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Open Access 01-12-2009 | Study protocol

Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: A cluster randomised controlled trial of knowledge transfer

Authors: Sandy Middleton, Christopher Levi, Jeanette Ward, Jeremy Grimshaw, Rhonda Griffiths, Catherine D'Este, Simeon Dale, N Wah Cheung, Clare Quinn, Malcolm Evans, Dominique Cadilhac

Published in: Implementation Science | Issue 1/2009

Abstract

Background

Hyperglycaemia, fever, and swallowing dysfunction are poorly managed in the admission phase of acute stroke, and patient outcomes are compromised. Use of evidence-based guidelines could improve care but have not been effectively implemented. Our study aims to develop and trial an intervention based on multidisciplinary team-building to improve management of fever, hyperglycaemia, and swallowing dysfunction in patients following acute stroke.

Methods and design

Metropolitan acute stroke units (ASUs) located in New South Wales, Australia will be stratified by service category (A or B) and, within strata, by baseline patient recruitment numbers (high or low) in this prospective, multicentre, single-blind, cluster randomised controlled trial (CRCT). ASUs then will be randomised independently to either intervention or control groups. ASUs allocated to the intervention group will receive: unit-based workshops to identify local barriers and enablers; a standardised core education program; evidence-based clinical treatment protocols; and ongoing engagement of local staff. Control group ASUs will receive only an abridged version of the National Clinical Guidelines for Acute Stroke Management. The following outcome measures will be collected at 90 days post-hospital admission: patient death, disability (modified Rankin Score); dependency (Barthel Index) and Health Status (SF-36). Additional measures include: performance of swallowing screening within 24 hours of admission; glycaemic control and temperature control.

Discussion

This is a unique study of research transfer in acute stroke. Providing optimal inpatient care during the admission phase is essential if we are to combat the rising incidence of debilitating stroke. Our CRCT will also allow us to test interventions focussed on multidisciplinary ASU teams rather than individual disciplines, an imperative of modern hospital services.

Trial Registration

Australia New Zealand Clinical Trial Registry (ANZCTR) No: ACTRN12608000563369

Available only for authorised users

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Title: Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: A cluster randomised controlled trial of knowledge transfer
Authors: Sandy Middleton
Christopher Levi
Jeanette Ward
Jeremy Grimshaw
Rhonda Griffiths
Catherine D'Este
Simeon Dale
N Wah Cheung
Clare Quinn
Malcolm Evans
Dominique Cadilhac
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: Implementation Science / Issue 1/2009
Electronic ISSN: 1748-5908
DOI: https://doi.org/10.1186/1748-5908-4-16

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: A cluster randomised controlled trial of knowledge transfer

Abstract

Background

Methods and design

Discussion

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and design

Discussion

Trial Registration

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