Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial
Sandy Middleton, Patrick McElduff, Jeanette Ward, Jeremy M Grimshaw, Simeon Dale, Catherine D'Este, Peta Drury, Rhonda Griffiths, N Wah Cheung, Clare Quinn, Malcolm Evans, Dominique Cadilhac, Christopher Levi
The Lancet | ELSEVIER SCIENCE INC | Published : 2011
BACKGROUND: We assessed patient outcomes 90 days after hospital admission for stroke following a multidisciplinary intervention targeting evidence-based management of fever, hyperglycaemia, and swallowing dysfunction in acute stroke units (ASUs). METHODS: In the Quality in Acute Stroke Care (QASC) study, a single-blind cluster randomised controlled trial, we randomised ASUs (clusters) in New South Wales, Australia, with immediate access to CT and on-site high dependency units, to intervention or control group. Patients were eligible if they spoke English, were aged 18 years or older, had had an ischaemic stroke or intracerebral haemorrhage, and presented within 48 h of onset of symptoms. Int..View full abstract
Awarded by National Health & Medical Research Council
This study was funded by the National Health & Medical Research Council (Project Grant ID 353803), St Vincent's Clinic Foundation, the Curran Foundation, Australian Diabetes Society-Servier, the College of Nursing, and Australian Catholic University. We would like to acknowledge the valuable contribution to the study governance of the QASC Trialists Group, the QASC steering committee, and the QASC expert advisory committee. We also would like to acknowledge the valuable contribution of the Stroke Unit Directors, Stroke Clinical Nurse Consultants, Clinical Nurse Educators, Stroke Liaison Nurses, Stroke Unit Coordinators, Clinical Research Assistants, and others from participating stroke units who assisted our trial; without their contribution, this trial would not have been possible.