Excellence in regional stroke care: An evaluation of the implementation of a stroke care unit in regional Australia

Journal article

McCann, Leanne, Groot, Patrick, Charnley, Chris and Gardner, Anne. (2009). Excellence in regional stroke care: An evaluation of the implementation of a stroke care unit in regional Australia. Australian Journal of Rural Health. 17(5), pp. 273 - 278. https://doi.org/10.1111/j.1440-1584.2009.01098.x
AuthorsMcCann, Leanne, Groot, Patrick, Charnley, Chris and Gardner, Anne
Abstract

Objective: To assess the effectiveness of a formalised stroke service in a regional hospital. Design: A pretest post-test design. Setting: An acute stroke unit in a regional health service. Participants: Overall sample comprised 80 patients with 36 (45.0%) men. Forty patients (19 men, 21 women) comprised pre-intervention group and 40 (17 men, 23 women) post-intervention group. Interventions: Establishment of an acute stroke unit. Main outcome measure(s): Increased frequency in meeting key performance indicators for acute stroke care as recommended by National Stroke Foundation. Results: On discharge, fewer survivors in the pre-intervention group were independent (n = 5) and returned home (n = 9) than the post-intervention group (n = 13) for both independent and returned home. More survivors in the pre-intervention group were discharged to aged care or inpatient rehab (n = 22) than the post-intervention group (n = 12). Within required time frames, the frequency of CT scans (χ2 (1, 80) = 4.1, P < 0.05), swallow assessments (χ2 (1, 80) = 9.0, P < 0.01), occupational therapy assessments (χ2 (1, 80) = 14.5, P < 0.0001), multidisciplinary meetings involving patient and family (χ2 (1, 80) = 19.9, P < 0.0001) and self-management plans (χ2 (1, 80) = 10.9, P < 0.05) all increased significantly. Conclusions: Our evaluation demonstrated that introduction of formalised stroke care to a regional hospital resulted in improved compliance with key performance indicators and better patient outcomes. Thus evidence-based specialised stroke care can be offered with confidence in regional populations.

Keywordsacute stroke unit; nursing; regional health; rural health; stroke care
Year2009
JournalAustralian Journal of Rural Health
Journal citation17 (5), pp. 273 - 278
PublisherWiley-Blackwell
ISSN1038-5282
Digital Object Identifier (DOI)https://doi.org/10.1111/j.1440-1584.2009.01098.x
Page range273 - 278
Research GroupSchool of Nursing, Midwifery and Paramedicine
Place of publicationAustralia
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McArdle, Joleen and Gardner, Anne. (2009). A literature review of central venous catheter dressings: Implications for haemodialysis in the tropics. Infection, Disease and Health. 14(4), pp. 139 - 146. https://doi.org/10.1071/HI09014
Writing ourselves into a web of obedience: A nursing policy analysis
Bail, Kasia, Cook, Robert, Gardner, Anne and Grealish, Laurie. (2009). Writing ourselves into a web of obedience: A nursing policy analysis. International Journal of Nursing Studies. 46(11), pp. 1457 - 1466. https://doi.org/10.1016/j.ijnurstu.2009.04.005
Potential scope and impact of a transboundary model of nurse practitioners in aged care
Bail, Kasia, Arbon, Paul, Eggert, Marlene, Gardner, Anne, Hogan, Sonia, Phillips, Christine, van Dieman, Nicole and Waddington, Gordon. (2009). Potential scope and impact of a transboundary model of nurse practitioners in aged care. Australian Journal of Primary Health. 15(3), pp. 232 - 237. https://doi.org/10.1071/PY09009
Patients' and nurses' perspectives on oxygen therapy: A qualitative study
Eastwood, Glenn, O'Connell, Beverley, Gardner, Anne and Considine, Julie. (2009). Patients' and nurses' perspectives on oxygen therapy: A qualitative study. Journal of Advanced Nursing. 65(3), pp. 634 - 641. https://doi.org/10.1111/j.1365-2648.2008.04933.x
Reporting a research project on the potential of aged care nurse practitioners in the Australian capital territory
Arbon, Paul, Bail, Kasia, Eggert, Marlene, Gardner, Anne, Hogan, Sonia, Phillips, Christine, van Dieman, Nicole and Waddington, Gordon. (2009). Reporting a research project on the potential of aged care nurse practitioners in the Australian capital territory. Journal of Clinical Nursing. 18(2), pp. 255 - 262. https://doi.org/10.1111/j.1365-2702.2008.02452.x
Selecting the right integration of research into practice strategy
Eastwood, Glenn, O'Connell, Beverley and Gardner, Anne. (2008). Selecting the right integration of research into practice strategy. Journal of Nursing Care Quality. 23(3), pp. 258 - 264. https://doi.org/10.1097/01.NCQ.0000324591.76590.e9
From competence to capability: A study of nurse practitioners in clinical practice
Gardner, Anne, Hase, Stewart, Gardner, Glenn, Dunn, Sandra and Carryer, Jenny. (2008). From competence to capability: A study of nurse practitioners in clinical practice. Journal of Clinical Nursing. 17(2), pp. 250 - 258. https://doi.org/10.1111/j.1365-2702.2006.01880.x
Evaluation of nasopharyngeal oxygen, nasal prongs and facemask oxygen therapy devices in adult patients: A randomised crossover trial
Eastwood, Glenn, O'Connell, Beverley, Gardner, Anne and Considine, Julie. (2008). Evaluation of nasopharyngeal oxygen, nasal prongs and facemask oxygen therapy devices in adult patients: A randomised crossover trial. Anaesthesia and Intensive Care. 36(5), pp. 691 - 694.
The core role of the nurse practitioner: practice, professionalism and clinical leadership
Carryer, Jenny, Gardner, Glenn, Dunn, Sandra and Gardner, Anne. (2007). The core role of the nurse practitioner: practice, professionalism and clinical leadership. Journal of Clinical Nursing. 16(10), pp. 1818 - 1825. https://doi.org/10.1111/j.1365-2702.2007.01823.x
Living with chronic illness
Gardner, Glenn and Gardner, Anne. (2007). Living with chronic illness. In In McAllister, Margaret (Ed.). Solution focused nursing : Rethinking practice pp. 143-153 Palgrave Macmillan.
Dealing with data: optimising data consistency to demonstrate the value of nurse practitioner service
Gardner, Anne, Millar, Lynne and Driscoll, Andrea. (2007). Dealing with data: optimising data consistency to demonstrate the value of nurse practitioner service. The Nurse Practitioner Series. 2(1), pp. 19 - 25.
Intravascular catheter bloodstream infections: An effective and sustained hospital-wide prevention program over 8 years
Collignon, Peter J., eimanis, Dianne E., Beckingham, Wendy D., Roberts, Jan L. and Gardner, Anne. (2007). Intravascular catheter bloodstream infections: An effective and sustained hospital-wide prevention program over 8 years. Medical Journal of Australia. 187(10), pp. 551 - 554.
The capability of nurse practitioners may be diminished by controlling protocols
Carryer, Jenny, Gardner, Glenn, Dunn, Sandra and Gardner, Anne. (2007). The capability of nurse practitioners may be diminished by controlling protocols. Australian Health Review. 31(1), pp. 108 - 115. https://doi.org/10.1071/AH070108
Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings
O'Connell, Beverley, Gardner, Anne, Takase, Miyuki, Hawkins, Mary, Ostaszkiewicz, Joan, Ski, Chantal and Josipovic, Patricia. (2007). Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings. International Journal of Nursing Practice. 13(3), pp. 182 - 192. https://doi.org/10.1111/j.1440-172X.2007.00624.x
Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory
O'Keefe, Elissa, Gardner, Anne, Currie, Marian, Garland, Suzanne, Tabrizi, Sepehr and Bowden, Francis. (2006). Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory. Sexual Health. 3(2), pp. 91 - 94. https://doi.org/10.1071/SH05047
Competency and capability: imperative for nurse practitioner education
Gardner, Glenn, Carryer, Jenny, Dunn, Sandra and Gardner, Anne. (2006). Competency and capability: imperative for nurse practitioner education. Australian Journal of Advanced Nursing. 24(1), pp. 8 - 14.
Using a monitored sip test to assess risk of aspiration in postoperative patients
Osborne, Sonya, Gardner, Glenn, Gardner, Anne, Franklin, Susan, Tuohy, Elizabeth and Fisher, Alex. (2006). Using a monitored sip test to assess risk of aspiration in postoperative patients. AORN Journal. 83(4), pp. 908 - 928. https://doi.org/10.1016/S0001-2092(06)60010-0
Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommendations for practice
Feeley, Kathy and Gardner, Anne. (2006). Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommendations for practice. Australian Critical Care. 19(2), pp. 73 - 77. https://doi.org/10.1016/S1036-7314(06)80012-3
How ophthalmic day surgery patients convalesce at home: an exploration of the salient issues
Ryan, Fiona, O'Connell, Beverley and Gardner, Anne. (2006). How ophthalmic day surgery patients convalesce at home: an exploration of the salient issues. Day Surgery Australia. 5(3), pp. 11 - 16.
Pressure injury: an exploration of the relationship between risk factors and interface pressure
Gardner, Anne, Dunk, Ann Marie, Eggert, Marlene, Gardner, Glenn and Wellman, David. (2006). Pressure injury: an exploration of the relationship between risk factors and interface pressure. Wound Practice & Research. 14(4), pp. 140 - 149.
Nurse Practitioner competency standards: Findings from collaborative Australian and New Zealand research
Gardner, Glenn, Carryer, Jenny, Gardner, Anne and Dunn, Sandra. (2006). Nurse Practitioner competency standards: Findings from collaborative Australian and New Zealand research. International Journal of Nursing Studies. 43(5), pp. 601 - 610. https://doi.org/10.1016/j.ijnurstu.2005.09.002
A trial of nurse practitioner scope of practice
Gardner, Anne and Gardner, Glenn. (2005). A trial of nurse practitioner scope of practice. Journal of Advanced Nursing. 49(2), pp. 135 - 145. https://doi.org/10.1111/j.1365-2648.2004.03273.x
Best practice in stabilisation of oral endotracheal tubes: a systematic review
Gardner, Anne, Hughes, Dot, Cook, Robert, Henson, Rachael, Osborne, Sonya and Gardner, Glenn. (2005). Best practice in stabilisation of oral endotracheal tubes: a systematic review. Australian Critical Care. 18(4), pp. 158 - 165. https://doi.org/10.1016/S1036-7314(05)80029-3
Parenting a preterm infant: Experiences in a regional neonatal health services programme
Rowe, Jennifer, Gardner, Glenn and Gardner, Anne. (2005). Parenting a preterm infant: Experiences in a regional neonatal health services programme. Neonatal, Paediatric and Child Health Nursing. 8(1), pp. 17 - 23.