Cluster-randomized trial of thrombolysis implementation support in metropolitan and regional Australian stroke centers : Lessons for individual and systems behavior change

Journal article


Levi, Christopher R., Attia, John A., D'Este, Cate, Ryan, Annika E., Henskens, Frans, Kerr, Erin, Parsons, Mark William, Sanson-Fisher, Robert W., Bladin, Christopher F., Lindley, Richard I., Middleton, Sandy, Paul, Christine L. and the TIPS (Thrombolysis Implementation in Stroke) Study Group. (2020). Cluster-randomized trial of thrombolysis implementation support in metropolitan and regional Australian stroke centers : Lessons for individual and systems behavior change. Journal of the American Heart Association. 9(3), p. Article e012732. https://doi.org/10.1161/JAHA.119.012732
AuthorsLevi, Christopher R., Attia, John A., D'Este, Cate, Ryan, Annika E., Henskens, Frans, Kerr, Erin, Parsons, Mark William, Sanson-Fisher, Robert W., Bladin, Christopher F., Lindley, Richard I., Middleton, Sandy, Paul, Christine L. and the TIPS (Thrombolysis Implementation in Stroke) Study Group
Abstract

Background
Intravenous thrombolytic therapy (IVT) with tissue plasminogen activator for acute ischemic stroke is underutilized in many parts of the world. Randomized trials to test the effectiveness of thrombolysis implementation strategies are limited.

Methods and Results
This study aimed to test the effectiveness of a multicomponent, multidisciplinary tissue plasminogen activator implementation package in increasing the proportion of thrombolyzed cases while maintaining accepted benchmarks for low rates of intracranial hemorrhage and high rates of functional outcomes at 3 months. A cluster randomized controlled trial of 20 hospitals in the early stages of thrombolysis implementation across 3 Australian states was undertaken. Monitoring of IVT rates during the baseline period allowed hospitals (the unit of randomization) to be grouped into 3 baseline IVT strata—very low rates (0% to ≤4.0%); low rates (>4.0% to ≤10.0%); and moderate rates (>10.0%). Hospitals were randomized to an implementation package (experimental group) or usual care (control group) using a 1:1 ratio. The 16‐month intervention was based on behavioral theory and analysis of the steps, roles, and barriers to rapid assessment for thrombolysis eligibility and involved comprehensive strategies addressing individual and system‐level change. The primary outcome was the difference in tissue plasminogen activator proportions between the 2 groups postintervention. The absolute difference in postintervention IVT rates between intervention and control hospitals adjusted for baseline IVT rate and stratum was not significant (primary outcome rate difference=1.1% (95% CI −1.5% to 3.7%; P=0.38). Rates of intracranial hemorrhage remained below international benchmarks.

Conclusions
The implementation package resulted in no significant change in tissue plasminogen activator implementation, suggesting that ongoing support is needed to sustain initial modifications in behavior.

Clinical Trial Registration
URL: www.anzctr.org.au Unique identifiers: ACTRN12613000939796 and U1111‐1145‐6762

Keywordshealth system change; implementation; ischemic stroke; quality improvement; thrombolysis
Year2020
JournalJournal of the American Heart Association
Journal citation9 (3), p. Article e012732
PublisherWiley-Blackwell Publishing, Inc.
ISSN2047-9980
Digital Object Identifier (DOI)https://doi.org/10.1161/JAHA.119.012732
PubMed ID31973599
Scopus EID2-s2.0-85078296219
PubMed Central IDPMC7033885
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range1-13
FunderNational Health and Medical Research Council (NHMRC)
Research GroupNursing Research Institute
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online24 Jan 2020
Publication process dates
Accepted15 Nov 2019
Grant IDNHMRC/569328
NHMRC/1043913
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Middleton, Sandy, Gardner, Glenn, Gardner, Anne, Considine, Julie, Fitzgerald, Gerard, Christofis, Luke, Doubrovsky, Anna, Della, Phillip, Fasugba, Oyebola and D'Este, Catherine. (2019). Are service and patient indicators different in the presence or absence of nurse practitioners? The EDPRAC cohort study of Australian emergency departments. BMJ Open. 9(7), p. Article e024529. https://doi.org/10.1136/bmjopen-2018-024529
Maximising data value and avoiding data waste : A validation study in stroke research
Kilkenny, Monique F., Kim, Joosup, Andrew, Nadine E., Sundararajan, Vijaya, Thrift, Amanda G., Katzenellenbogen, Judith M., Flack, Felicity, Gattellari, Melina, Boyd, James H., Anderson, Phil, Lannin, Natasha, Sipthorp, Mark, Chen, Ying, Johnston, Trisha, Anderson, Craig S., Middleton, Sandy, Donnan, Geoffrey A. and Cadihac, Dominique A.. (2019). Maximising data value and avoiding data waste : A validation study in stroke research. Medical Journal of Australia. 210(1), pp. 27-31. https://doi.org/10.5694/mja2.12029
Does the addition of non-approved inclusion and exclusion criteria for rtPA impact treatment rates? Findings in Australia, the UK, and the USA
Craig, Louise E., Middleton, Sandy, Hamilton, Helen, Cudlip, Fern, Swatzell, Victoria, Alexandrov, Andrei V., Lightbody, Elizabeth, Watkins, Caroline, Philip, Sheeba, Cadihac, Dominique A., McInnes, Elizabeth, Dale, Simeon and Alexandrov, Anne W.. (2019). Does the addition of non-approved inclusion and exclusion criteria for rtPA impact treatment rates? Findings in Australia, the UK, and the USA. Interventional Neurology. 8(1), pp. 1-12. https://doi.org/10.1159/000493020
Weekend hospital discharge is associated with suboptimal care and outcomes : An observational Australian Stroke Clinical Registry study
Kilkenny, Monique F., Lannin, Natasha A., Levi, Christopher, Faux, Steve G., Dewey, Helen M., Grimley, Rohan, Hill, Kelvin, Grabsch, Brenda, Kim, Joosup, Hand, Peter, Crosby, Vanessa, Gardner, Michele, Rois-Gnecco, Juan, Thijs, Vincent, Anderson, Craig S., Donnan, Geoffrey A., Middleton, Sandy and Cadilhac, Dominique A.. (2019). Weekend hospital discharge is associated with suboptimal care and outcomes : An observational Australian Stroke Clinical Registry study. International Journal of Stroke. 14(4), pp. 430-438. https://doi.org/10.1177/1747493018806165
Vital sign monitoring following stroke associated with 90-day independence : A secondary analysis of the QASC cluster randomized trial
Middleton, Sandy, McElduff, Patrick, Drury, Peta, D'Este, Catherine, Cadilhac, Dominique A., Dale, Simeon, Grimshaw, Jeremy M., Ward, Jeanette, Quinn, Clare, Cheung, N. Wah and Levi, Chris. (2019). Vital sign monitoring following stroke associated with 90-day independence : A secondary analysis of the QASC cluster randomized trial. International Journal of Nursing Studies. 89, pp. 72-79. https://doi.org/10.1016/j.ijnurstu.2018.09.014
Blood pressure variability and outcome in acute ischemic and hemorrhagic stroke : A post hoc analysis of the HeadPoST study
Minhas, Jatinder S., Wang, Xia, Lavados, Pablo M., Moullaali, Tom J., Arima, Hisatomi, Billot, Laurent, Hackett, Maree L., Olavarria, Veronica V., Middleton, Sandy, Pontes-Neto, Octavio, De Silva, H. Asita, Lee, Tsong-Hai, Pandian, Jeyaraj D., Mead, Gillian E., Watkins, Caroline, Chalmers, John, Anderson, Craig S. and Robinson, Thompson G.. (2019). Blood pressure variability and outcome in acute ischemic and hemorrhagic stroke : A post hoc analysis of the HeadPoST study. Journal of Human Hypertension. 33(5), pp. 411-418. https://doi.org/10.1038/s41371-019-0193-z
Multicenter, prospective, controlled, before-and-after, quality improvement study (Stroke123) of acute stroke care
Cadilhac, Dominique A., Grimley, Rohan, Kilkenny, Monique F., Andrew, Nadine E., Lannin, Natasha A., Hill, Kelvin, Grabsch, Brenda, Levi, Chris, Thrift, Amanda G., Faux, Steven G., Wakefield, John, Cadigan, Greg, Donnan, Geoffrey A., Middleton, Sandy and Anderson, Craig S.. (2019). Multicenter, prospective, controlled, before-and-after, quality improvement study (Stroke123) of acute stroke care. Stroke. 50(6), pp. 1525-1530. https://doi.org/10.1161/STROKEAHA.118.023075
Validating the Alberta Context Tool in a multi-site Australian emergency department nurse population
Schadewaldt, Verena, McElduff, Benjamin, D'Este, Catherine, McInnes, Elizabeth, Dale, Simeon, Gunaratne, Anoja, Squires, Janet, Cadilhac, Dominique A. and Middleton, Sandy. (2019). Validating the Alberta Context Tool in a multi-site Australian emergency department nurse population. PLoS ONE. 14(4), p. Article e0215153. https://doi.org/10.1371/journal.pone.0215153
Hospital organizational context and delivery of evidence-based stroke care : A cross sectional study
Andrew, Nadine E., Middleton, Sandy, Grimley, Rohan, Anderson, Craig S., Donnan, Geoffrey A., Lannin, Natasha A., Stroil-Salama, Enna, Grabsch, Brenda, Kilkenny, Monique F., Squires, Janet E. and Cadilhac, Dominique A.. (2019). Hospital organizational context and delivery of evidence-based stroke care : A cross sectional study. Implementation Science. 14, p. Article 6. https://doi.org/10.1186/s13012-018-0849-z
Prescription of antihypertensive medication at discharge influences survival following stroke
Andrew, Nadine E., Kim, Joosup, Thrift, Amanda, Kilkenny, Monique F., Lannin, Natasha, Anderson, Craig, Donnan, Geoffrey A., Hill, Kelvin, Middleton, Sandy, Levi, Chris, Faux, Steve, Grimley, Rohan, Gange, Nisal, Geraghty, Richard, Ermel, Sharan and Cadilhac, Dominique A.. (2018). Prescription of antihypertensive medication at discharge influences survival following stroke. Neurology. 90(9), pp. e745-e753. https://doi.org/10.1212/WNL.0000000000005023
Implementing a protocol for a research impact assessment of the Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery
Ramanathan, Shanthi, Reeves, Penny, Deeming, Simon, Bernhardt, Julie, Nilsson, Michael, Cadihac, Dominique A., Walker, Frederick Rohan, Carey, Leeanne, Middleton, Sandy, Lynch, Elizabeth and Searles, Andrew. (2018). Implementing a protocol for a research impact assessment of the Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery. Health Research Policy and Systems. 16(1), p. Article 71. https://doi.org/10.1186/s12961-018-0349-2
Statistical analysis plan (SAP) for the Very Early Rehabilitation in Speech (VERSE) after stroke trial : An international 3-arm clinical trial to determine the effectiveness of early, intensive, prescribed, direct aphasia therapy
Godecke, Erin, Rai, Tapan, Cadihac, Dominique A., Armstrong, Elizabeth, Middleton, Sandy, Ciccone, Natalie, Whitworth, Anne, Rose, Miranda L., Holland, Audrey, Ellery, Fiona, Hankey, Graeme J. and Bernhardt, Julie. (2018). Statistical analysis plan (SAP) for the Very Early Rehabilitation in Speech (VERSE) after stroke trial : An international 3-arm clinical trial to determine the effectiveness of early, intensive, prescribed, direct aphasia therapy. International Journal of Stroke. 13(8), pp. 863-880. https://doi.org/10.1177/1747493018790055
Improving the quality of healthcare : A cross-sectional study of the features of successful clinical networks
Haines, Mary M., Brown, Bernadette, D'Este, Catherine, Yano, Elizabeth M., Craig, Jonathon C., Middleton, Sandy, Castaldi, Peter A., Pollock, Carol A., Needham, Kate, Watt, William H., Elliott, Elizabeth J., Scott, Anthony, Dominello, Amanda, Klineberg, Emily, Atkinson, Jo-An, Paul, Christine and Redman, Sally. (2018). Improving the quality of healthcare : A cross-sectional study of the features of successful clinical networks. Public Health Research and Practice. 28(4), p. Article e28011803. https://doi.org/10.17061/phrp28011803
A mixed methods study to explore opinions of research translation held by researchers working in a Centre of Research Excellence in Australia
Lynch, Elizabeth A., Ramanathan, Shanthi, Middleton, Sandy, Bernhardt, Julie, Nilsson, Michael and Cadilhac, Dominique A.. (2018). A mixed methods study to explore opinions of research translation held by researchers working in a Centre of Research Excellence in Australia. BMJ Open. 8, p. Article e022357. https://doi.org/10.1136/bmjopen-2018-022357
Back to basics : Adherence with guidelines for glucose and temperature control in an American comprehensive stroke center sample
Alexandrov, Anne W., Palazzo, Paola, Biby, Sharon, Doerr, Abbigayle, Dusenbury, Wendy, Young, Rhonda, Lindstrom, Anne, Grove, Mary, Tsivgoulis, Georgios, Middleton, Sandy and Alexandrov, Andrei V.. (2018). Back to basics : Adherence with guidelines for glucose and temperature control in an American comprehensive stroke center sample. Journal of Neuroscience Nursing. 50(3), pp. 131-137. https://doi.org/10.1097/JNN.0000000000000358
Mapping workforce configuration and operational models in australian emergency departments : A national survey
Gardner, Glenn, Gardner, Anne, Middleton, Sandy, Considine, Julie, Fitzgerald, Gerard, Christofis, Luke, Doubrovsky, Anna, Adams, Margaret and O'Connell, Jane. (2018). Mapping workforce configuration and operational models in australian emergency departments : A national survey. Australian Health Review. 42(3), pp. 340-347. https://doi.org/10.1071/AH16231
Improving quality and outcomes of stroke care in hospitals : Protocol and statistical analysis plan for the Stroke 123 implementation study
Cadilhac, Dominique A., Andrew, Nadine E., Kilkenny, Monique F., Hill, Kelvin, Grabsch, Brenda, Lannin, Natasha A., Thrift, Amanda G., Anderson, Craig S., Donnan, Geoffrey A., Middleton, Sandy and Grimley, Rohan. (2018). Improving quality and outcomes of stroke care in hospitals : Protocol and statistical analysis plan for the Stroke 123 implementation study. International Journal of Stroke. 13(1), pp. 96-106. https://doi.org/10.1177/1747493017730741
Quality of life is poorer for patients with stroke who require an interpreter : An observational Australian Registry study
Kilkenny, Monique F., Lannin, Natasha A., Anderson, Craig S., Dewey, Helen M., Kim, Joosup, Barclay-Moss, Karen, Levi, Chris, Faux, Steven, Hill, Kelvin, Grabsch, Brenda, Middleton, Sandy, Thrift, Amanda G., Grimley, Rohan, Donnan, Geoffrey and Cadilhac, Dominique A.. (2018). Quality of life is poorer for patients with stroke who require an interpreter : An observational Australian Registry study. Stroke. 49(3), pp. 761-764. https://doi.org/10.1161/STROKEAHA.117.019771
What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes
Aminov, Anna, Rogers, Jeffrey M., Middleton, Sandy, Caeyenberghs, Karen and Wilson, Peter H.. (2018). What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes. Journal of NeuroEngineering and Rehabilitation. 15(29), p. Article 29. https://doi.org/10.1186/s12984-018-0370-2
Treatment with exenatide in acute ischaemic stroke trial protocol : A prospective, randomised, open label, blinded end-point study of exenatide vs. standard care in post stroke hyperglycaemia
Muller, Claire, Cheung, N. Wah, Dewey, Helen, Churilov, Leonid, Middleton, Sandy, Thijs, Vincent, Ekinci, Elif I., Levi, Chris, Lindley, Richard, Donnan, Geoffrey, Parsons, Mark and Bladin, Christopher. (2018). Treatment with exenatide in acute ischaemic stroke trial protocol : A prospective, randomised, open label, blinded end-point study of exenatide vs. standard care in post stroke hyperglycaemia. International Journal of Stroke. 13(8), pp. 857-862. https://doi.org/10.1177/1747493018784436
Is length of time in a stroke unit associated with better outcomes for patients with stroke in Australia? An observational study
Busingye, Doreen, Kilkenny, Monique F., Purvis, Tara, Kim, Joosup, Middleton, Sandy, Campbell, Bruce C. V. and Cadihac, Dominique A.. (2018). Is length of time in a stroke unit associated with better outcomes for patients with stroke in Australia? An observational study. BMJ Open. 8(11), p. Article e022536. https://doi.org/10.1136/bmjopen-2018-022536
Implementation of a patient blood management program in an Australian private hospital orthopedic unit
Morgan, Paul N., Coleman, Patrick L., Martinez-Garduno, Cintia Mayel, Gunaratne, Anoja W., McInnes, Elizabeth and Middleton, Sandy. (2018). Implementation of a patient blood management program in an Australian private hospital orthopedic unit. Journal of Blood Medicine. 9, pp. 83-90. https://doi.org/10.2147/JBM.S157571
Interventions for the uptake of evidence-based recommendations in acute stroke settings
Luker, Julie A., Bernhardt, Julie, Graham, Ian D., Middleton, Sandy, Lynch, Elizabeth A., Thayabaranathan, Tharshanah, Craig, Louise and Cadilhac, Dominique A.. (2017). Interventions for the uptake of evidence-based recommendations in acute stroke settings. Cochrane Database of Systematic Reviews. 2017(1), p. Article CD012520. https://doi.org/10.1002/14651858.CD012520
Acute single channel EEG predictors of cognitive function after stroke
Aminov, Anna, Rogers, Jeffrey M., Johnstone, Stuart J., Middleton, Sandy and Wilson, Peter H.. (2017). Acute single channel EEG predictors of cognitive function after stroke. PLoS ONE. 12(10), p. Article e0185841. https://doi.org/10.1371/journal.pone.0185841
Barriers and enablers to adherence to anticoagulation in heart failure with atrial fibrillation : Patient and provider perspectives
Ferguson, Caleb, Inglis, Sally C., Newton, Phillip J., Middleton, Sandy, Macdonald, Peter S. and Davidson, Patricia M.. (2017). Barriers and enablers to adherence to anticoagulation in heart failure with atrial fibrillation : Patient and provider perspectives. Journal of Clinical Nursing. 26(23-24), pp. 4325-4334. https://doi.org/10.1111/jocn.13759
Mortality reduction for fever, hyperglycemia, and swallowing nurse-initiated stroke intervention : QASC trial (Quality In Acute Stroke Care) follow-up
Middleton, Sandy, Coughlan, Kelly, Mnatzaganian, George, Choy, Nancy Low, Dale, Simeon, Jammali-Blasi, Asmara, Levi, Chris, Grimshaw, Jeremy, Ward, Jeanette, Cadilhac, Dominique A., McElduff, Patrick, Hiller, Janet E. and D'Este, Catherine. (2017). Mortality reduction for fever, hyperglycemia, and swallowing nurse-initiated stroke intervention : QASC trial (Quality In Acute Stroke Care) follow-up. Stroke. 48(5), pp. 1331-1336. https://doi.org/10.1161/STROKEAHA.116.016038
Improving discharge care : The potential of a new organisational intervention to improve discharge after hospitalisation for acute stroke, a controlled before – after pilot study
Cadilhac, Dominique A., Andrew, Nadine E., Salama, Enna Stroil, Hill, Kelvin, Middleton, Sandy, Horton, Eleanor, Meade, Ian, Kuhle, Sarah, Nelson, Mark R. and Grimley, Rohan. (2017). Improving discharge care : The potential of a new organisational intervention to improve discharge after hospitalisation for acute stroke, a controlled before – after pilot study. BMJ Open. 7(8), p. Article e016010. https://doi.org/10.1136/bmjopen-2017-016010
Testing a systematic approach to identify and prioritise barriers to successful implementation of a complex healthcare intervention
Craig, Louise E., Churilov, Leonid, Olenko, Liudmyla, Cadilhac, Dominique A., Grimley, Rohan, Dale, Simeon, Martinez-Garduno, Cintia, McInnes, Elizabeth, Considine, Julie, Grimshaw, Jeremy M. and Middleton, Sandy. (2017). Testing a systematic approach to identify and prioritise barriers to successful implementation of a complex healthcare intervention. BMC Medical Research Methodology. 17(1), p. Article 24. https://doi.org/10.1186/s12874-017-0298-4
Treatment and outcomes of working aged adults with stroke : Results from a national prospective registry
Lannin, Natasha A., Anderson, Craig S., Kim, Joosup, Kilkenny, Monique, Bernhardt, Julie, Levi, Christopher, Dewey, Helen M., Bladin, Christopher, Hand, Peter, Castley, Helen, Hill, Kelvin, Faux, Steven, Grimley, Rohan, Grabsch, Brenda, Middleton, Sandy, Donnan, Geoffrey and Cadilhac, Dominique A.. (2017). Treatment and outcomes of working aged adults with stroke : Results from a national prospective registry. Neuroepidemiology. 49, pp. 113-120. https://doi.org/10.1159/000484141
Barriers and outcomes of an evidence-based approach to diagnosis and management of chronic obstructive pulmonary disease (COPD) in Australia : A qualitative study
Dennis, Sarah, Reddel, Helen K., Middleton, Sandy, Hasan, Iqbal, Hermiz, Oshana, Phillips, Rosemary, Crockett, Alan J., Vagholkar, Sanjyot, Marks, Guy B. and Zwar, Nicholas. (2017). Barriers and outcomes of an evidence-based approach to diagnosis and management of chronic obstructive pulmonary disease (COPD) in Australia : A qualitative study. Family Practice. 34(4), pp. 485-490. https://doi.org/10.1093/fampra/cmw103
Cluster-randomized, crossover trial of head positioning in acute stroke
Anderson, Craig S., Arima, Hisatomi, Lavados, Pablo, Billot, Laurent, Hackett, Maree L., Olavarria, Veronica, Muñoz Venturelli, Paula, Brunser, Alejandro, Peng, Bin, Cui, Liying, Song, Lily, Rogers, Kerrylee, Middleton, Sandy, Lim, Joyce Y., Forshaw, Denise, Lighbody, C. Elizabeth, Woodward, Mark, Pontes-Neto, Octavio, de Silva, H. Asita, ... Watkins, Caroline Leigh. (2017). Cluster-randomized, crossover trial of head positioning in acute stroke. The New England Journal of Medicine. 376(25), pp. 2437-2447. https://doi.org/10.1056/NEJMoa1615715
International uptake of a proven intervention to reduce death and dependency in acute stroke : A cross-sectional-survey following the QASC trial
Middleton, Sandy, Bruch, Dominik, Martinez-Garduno, Cintia M., Dale, Simeon and McNamara, Maria. (2017). International uptake of a proven intervention to reduce death and dependency in acute stroke : A cross-sectional-survey following the QASC trial. Worldviews on Evidence-Based Nursing. 14(6), pp. 447-454. https://doi.org/10.1111/wvn.12253
Risk-adjusted hospital mortality rates for stroke: evidence from the Australian Stroke Clinical Registry (AuSCR)
Cadihac, Dominique A., Kilkenny, Monique F., Levi, Christopher R., Lannin, Natasha A., Thrift, Amanda G., Kim, Joosup, Grabsch, Brenda, Churilov, Leonid, Dewey, Helen M., Hill, Kelvin, Faux, Steven G., Grimley, Rohan, Castley, Helen, Hand, Peter J., Wong, Andrew, Herkes, Geoffrey K., Gill, Melissa, Crompton, Douglas, Middleton, Sandy, ... Anderson, Craig S.. (2017). Risk-adjusted hospital mortality rates for stroke: evidence from the Australian Stroke Clinical Registry (AuSCR). Medical Journal of Australia. 206(8), pp. 345-350. https://doi.org/10.5694/mja16.00525
Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF) : The T3 Trial
Craig, Louise E., Taylor, Natalie, Grimley, Rohan, Cadilhac, Dominique A., McInnes, Elizabeth, Phillips, Rosemary, Dale, Simeon, O'Connor, Denise, Levi, Chris, Fitzgerald, Mark, Considine, Julie, Grimshaw, Jeremy M., Gerraty, Richard, Cheung, N. Wah, Ward, Jeanette and Middleton, Sandy. (2017). Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF) : The T3 Trial. Implementation Science. 12(1), p. Article 88. https://doi.org/10.1186/s13012-017-0616-6
Leaving a legacy of stroke in Europe : A community of dedicated professionals is changing the face of stroke in Europe
Mikulik, Robert, Ylikotila, Pauli, Roine, Risto, Brozman, Miroslav and Middleton, Sandy. (2017). Leaving a legacy of stroke in Europe : A community of dedicated professionals is changing the face of stroke in Europe. The CNS Journal. 3(1), pp. 8-18.
Multi-morbidity, frailty and self-care : Important considerations in treatment with anticoagulation drugs. Outcomes of the AFASTER study
Ferguson, Caleb, Inglis, Sally C., Newton, Phillip J., Middleton, Sandy, Macdonald, Peter S. and Davidson, Patricia M.. (2017). Multi-morbidity, frailty and self-care : Important considerations in treatment with anticoagulation drugs. Outcomes of the AFASTER study. European Journal of Cardiovascular Nursing. 16(2), pp. 113-124. https://doi.org/10.1177/1474515116642604
Hospital arrival times and post-imaging delays in stroke thrombolysis implementation
Kawano, Hiroyuki, Bivard, Andrew, Parsons, Mark W., Paul, Christine L., Krause, Martin, D'Este, Catherine, Bladin, Christopher F., Lindley, Richard I., Attia, John R., Henskens, Frans, Longworth, Mark, Middleton, Sandy, Ryan, Annika, Kerr, Erin, Sanson-Fisher, Robert W., Levi, Christopher R. and Thrombolysis ImPlementation in Stroke (TIPS) Study Group. (2017). Hospital arrival times and post-imaging delays in stroke thrombolysis implementation. Journal of Neurological Disorders & Stroke. 5(3), pp. 1-6.
Quality of acute care and long-term quality of life and survival
Cadilhac, Dominique A., Andrew, Nadine E., Lannin, Natasha A., Middleton, Sandy, Levi, Christopher R., Dewey, Helen M., Grabsch, Brenda, Faux, Steven, Hill, Kelvin, Grimley, Rohan, Wong, Andrew, Sabet, Arman, Butler, Ernest, Bladin, Christopher F., Bates, Timothy R., Groot, Patrick, Castley, Helen, Donnan, Geoffry A. and Anderson, Craig S.. (2017). Quality of acute care and long-term quality of life and survival. Stroke: a journal of cerebral circulation. 48(4), pp. 1026-1032. https://doi.org/10.1161/STROKEAHA.116.015714
Statistical analysis plan for the Head Position in Stroke Trial (HeadPoST) : An international cluster cross-over randomised trial
Billot, Laurent, Woodward, Mark, Arima, Hisatomi, Hackett, Maree, Muñoz Venturelli, Paula, Lavados, Pablo M., Brunser, Alejandro, Peng, Bin, Cui, Liying, Song, Lily, Heritier, Stephane, Jan, Stephen, Middleton, Sandy, Olavarría, Verónica V., Lim, Joyce, Robinson, Thompson, Pontes-Neto, Octavio, Watkins, Caroline L. and Anderson, Craig S.. (2017). Statistical analysis plan for the Head Position in Stroke Trial (HeadPoST) : An international cluster cross-over randomised trial. International Journal of Stroke. 12(6), pp. 667-670. https://doi.org/10.1177/1747493017701943
Effectiveness of a ‘do not interrupt’ bundled intervention to reduce interruptions during medication administration : A cluster randomised controlled feasibility study
Westbrook, Johanna I., Li, Ling, Hooper, Tamara D., Raban, Magda Z., Middleton, Sandy and Lehnbom, Elin C.. (2017). Effectiveness of a ‘do not interrupt’ bundled intervention to reduce interruptions during medication administration : A cluster randomised controlled feasibility study. BMJ Quality and Safety. 26(9), pp. 734-742. https://doi.org/10.1136/bmjqs-2016-006123
Influence of stroke coordinators on delivery of acute stroke care and hospital outcomes : An observational study
Purvis, Tara, Kilkenny, Monique F., Middleton, Sandy and Cadilhac, Dominique A.. (2017). Influence of stroke coordinators on delivery of acute stroke care and hospital outcomes : An observational study. International Journal of Stroke. 13(6), pp. 585-591. https://doi.org/10.1177/1747493017741382
Development and validation of a survey to measure features of clinical networks
Brown, Bernadette Bea, Haines, Mary, Middleton, Sandy, Paul, Christine, D'Este, Catherine, Klineberg, Emily and Elliot, Elizabeth. (2016). Development and validation of a survey to measure features of clinical networks. BMC Health Services Research. 16, p. Article 531. https://doi.org/10.1186/s12913-016-1800-0
A randomized controlled trial of very early rehabilitation in speech after stroke
Godecke, Erin, Armstrong, Elizabeth A., Rai, Tapan, Middleton, Sandy, Ciccone, Natalie, Whitworth, Anne, Rose, Miranda, Holland, Audrey, Ellery, Fiona, Hankey, Graeme J., Cadilhac, Dominique A. and Bernhardt, Julie. (2016). A randomized controlled trial of very early rehabilitation in speech after stroke. International Journal of Stroke. 11(5), pp. 586-592. https://doi.org/10.1177/1747493016641116
Early intervention for chronic obstructive pulmonary disease by practice nurse and GP teams : A cluster randomized trial
Zwar, Nicholas A., Bunker, Jeremy M., Reddel, Helen K., Dennis, Sarah M., Middleton, Sandy, van Schayck, Onno C. P., Crockett, Alan J., Hasan, Iqbal, Hermiz, Oshana, Vagholkar, Sanjyot, Xuan, Wei and Mark, Guy B.. (2016). Early intervention for chronic obstructive pulmonary disease by practice nurse and GP teams : A cluster randomized trial. Family Practice. 33(6), pp. 663-670. https://doi.org/10.1093/fampra/cmw077
From QASC to QASCIP : Successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pretest/post-test study design
Middleton, Sandy, Lydtin, Anna, Comerford, Daniel, Cadilhac, Dominique A., McElduff, Patrick, Dale, Simeon, Hill, Kelvin, Longworth, Mark, Ward, Jeanette, Cheung, N. Wah and D'Este, Cate. (2016). From QASC to QASCIP : Successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pretest/post-test study design. BMJ Open. 6(5), p. Article e011568. https://doi.org/10.1136/bmjopen-2016-011568
Identifying the barriers and enablers for a triage, treatment, and transfer clinical intervention to manage acute stroke patients in the emergency department : A systematic review using the theoretical domains framework (TDF)
Craig, Louise E., McInnes, Elizabeth, Taylor, Natalie, Grimley, Rohan, Cadilhac, Dominique A., Considine, Julie and Middleton, Sandy. (2016). Identifying the barriers and enablers for a triage, treatment, and transfer clinical intervention to manage acute stroke patients in the emergency department : A systematic review using the theoretical domains framework (TDF). Implementation Science. 11, p. Article 157. https://doi.org/10.1186/s13012-016-0524-1
Education and practice gaps on atrial fibrillation and anticoagulation: A survey of cardiovascular nurses
Ferguson, Caleb, Inglis, Sally C., Newton, Phillip J., Middleton, Sandy, Macdonald, Peter S. and Davidson, Patricia M.. (2016). Education and practice gaps on atrial fibrillation and anticoagulation: A survey of cardiovascular nurses. BMC Medical Education. 16, p. Article 9. https://doi.org/10.1186/s12909-015-0504-1
How has the profile of Australian Nurse practitioners changed over time?
Middleton, Sandy, Gardner, Anne, Della, Phillip R., Lam, Lawrence, Allnutt, Nissa and Gardner, Glenn. (2016). How has the profile of Australian Nurse practitioners changed over time? Collegian. 23(1), pp. 69-77. https://doi.org/10.1016/j.colegn.2014.10.004
Addressing the stroke evidence-treatment gap
Ferguson, Caleb, Hickman, Louise D., Lal, Sara, Newton, Phillip J., Kneebone, Ian I., Mcgowan, Sharon and Middleton, Sandy. (2016). Addressing the stroke evidence-treatment gap. Contemporary Nurse. 52(2-3), pp. 253-257. https://doi.org/10.1080/10376178.2016.1215235
Stroke unit nurse managers’ views of individual and organisational factors liable to influence evidence-based practice : A survey
Drury, Peta, McInnes, Elizabeth, Hardy, Jennifer, Dale, Simeon and Middleton, Sandy. (2016). Stroke unit nurse managers’ views of individual and organisational factors liable to influence evidence-based practice : A survey. International Journal of Nursing Practice. 22(2), pp. 169-178. https://doi.org/10.1111/ijn.12396
Triage, treatment and transfer of patients with stroke in emergency department trial (the T3 Trial) : A cluster randomised trial protocol
Middleton, Sandy, Levi, Chris, Dale, Simeon, Chung, N. Wah, McInnes, Elizabeth, Considine, Julie, D'Este, Catherine, Cadilhac, Dominique A., Grimshaw, Jeremy, Gerraty, Richard, Craig, Louise, Schadewaldt, Verena, McElduff, Patrick, Fitzgerald, Mark, Quinn, Clare, Cadigan, Greg, Denisenko, Sonia, Longworth, Mark and Ward, Jeanette. (2016). Triage, treatment and transfer of patients with stroke in emergency department trial (the T3 Trial) : A cluster randomised trial protocol. Implementation Science. 11, p. Article 139. https://doi.org/10.1186/s13012-016-0503-6
What are the reasons for clinical network success? A qualitative study
McInnes, Elizabeth C., Haines, Mary, Dominello, Amanda, Kalucy, Deanna, Jammali-Blasi, Asmara, Middleton, Sandy and Klineberg, Emily. (2016). What are the reasons for clinical network success? A qualitative study. BMC Health Services Research. 15(497), p. Article 497. https://doi.org/10.1186/s12913-015-1096-5
Regional variation in acute stroke care organisation
Muñoz-Venturelli, Paula, Robinson, Thompson, Olavarría, Verónica V., Arima, Hisaromi, Billot, Laurent, Hackett, Maree L., Lim, Joyce y., Middleton, Sandy, Pontes-Neto, Octavio, Peng, Bin, Cui, Liying, Song, Lily, Mead, Gillian, Watkins, Caroline, Lin, Ruey-Tay, Lee, Tsong-Hai, Pandian, Jeyaraj, de Silva, H. Asita, Anderson, Craig S. and the HeadPoST Investigators. (2016). Regional variation in acute stroke care organisation. Journal of the Neurological Sciences. 371, pp. 126-130. https://doi.org/10.1016/j.jns.2016.10.026
A behaviour change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams : The Out-and-About trial
McCluskey, Annie, Ada, Louise, Kelly, Patrick J., Middleton, Sandy, Goodall, Stephen, Grimshaw, Jeremy M., Logan, Pip, Longworth, Mark and Karageorge, Aspasia. (2016). A behaviour change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams : The Out-and-About trial. International Journal of Stroke. 11(4), pp. 425-437. https://doi.org/10.1177/1747493016632246
A survey of acute care clinicians views on factors influencing hand hygiene practice and actions to improve hand hygiene compliance
Jammali-Blasi, Asmara, McInnes, Elizabeth and Middleton, Sandy. (2016). A survey of acute care clinicians views on factors influencing hand hygiene practice and actions to improve hand hygiene compliance. Infection, Disease and Health. 21(1), pp. 16-25. https://doi.org/10.1016/j.idh.2016.01.004
Better outcomes for hospitalized patients with TIA when in stroke units: An observational study
Cadilhac, Dominique A., Kim, Joosup, Lannin, Natasha A., Levi, Christopher R., Dewey, Helen M., Hill, Kelvin, Faux, Steven, Andrew, Nadine E., Kilkenny, Monique F., Grimley, Rohan, Thrift, Amanda G., Grabsch, Brenda, Middleton, Sandy, Anderson, Craig S. and Donnan, Geoffrey A.. (2016). Better outcomes for hospitalized patients with TIA when in stroke units: An observational study. Neurology. 86(22), pp. 2042-2048. https://doi.org/10.1212/WNL.0000000000002715
Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services : An observational cohort study
McCluskey, Annie, Ada, Louise, Kelly, Patrick J., Middleton, Sandy, Goodall, Stephen, Grimshaw, Jeremy M., Logan, Pip, Longworth, Mark and Karageorge, Aspasia. (2015). Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services : An observational cohort study. BMC Health Services Research. 15, p. Article 296. https://doi.org/10.1186/s12913-015-0952-7
Barriers and enablers to implementing clinical treatment protocols for fever, hyperglycaemia, and swallowing dysfunction in the Quality in Acute Stroke Care (QASC) Project — A mixed methods study
Dale, Simeon, Levi, Christopher, Ward, Jeanette, Grimshaw, Jeremy M., Jammali-Blasi, Asmara, D'Este, Catherine, Griffiths, Rhonda, Quinn, Clare, Evans, Malcolm, Cadilhac, Dominic, Cheung, N. Wah and Middleton, Sandy. (2015). Barriers and enablers to implementing clinical treatment protocols for fever, hyperglycaemia, and swallowing dysfunction in the Quality in Acute Stroke Care (QASC) Project — A mixed methods study. Worldviews on Evidence-Based Nursing. 12(1), pp. 41-50. https://doi.org/10.1111/wvn.12078
Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care : Effects of a targeted protocol implementation for nursing and medical staff
Knowles, Serena, Lam, Lawrence T., McInnes, Elizabeth, Elliott, Doug, Hardy, Jennifer and Middleton, Sandy. (2015). Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care : Effects of a targeted protocol implementation for nursing and medical staff. BMC Nursing. 14, p. Article 6. https://doi.org/10.1186/s12912-015-0056-z
Head Position in Stroke Trial (HeadPoST) – sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for a cluster randomised controlled trial
Muñoz-Venturelli, Paula, Arima, Hisatomi, Lavados, Pablo, Brunser, Alejandro, Peng, Bin, Cui, Liying, Song, Lily, Billot, Laurent, Boaden, Elizabeth, Hackett, Maree L., Heritier, Stephane, Jan, Stephen, Middleton, Sandy, Olavarría, Verónica V., Lim, Joyce Y., Lindley, Richard I., Heeley, Emma, Robinson, Thompson, Pontes-Neto, Octavio, ... Anderson, Craig S.. (2015). Head Position in Stroke Trial (HeadPoST) – sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for a cluster randomised controlled trial. Trials. 16, p. Article 256. https://doi.org/10.1186/s13063-015-0767-1
Triage, treatment and transfer : Evidence-based clinical practice recommendations and models of nursing care for the first 72 hours of admission to hospital for acute stroke
Middleton, Sandy, Grimley, Rohan and Alexandrov, Anne W.. (2015). Triage, treatment and transfer : Evidence-based clinical practice recommendations and models of nursing care for the first 72 hours of admission to hospital for acute stroke. Stroke. 46(2), pp. e18-e25. https://doi.org/10.1161/STROKEAHA.114.006139
The caregiver role in thromboprophylaxis management in atrial fibrillation : A literature review
Ferguson, Caleb, Inglis, Sally C., Newton, Phillip J., Middleton, Sandy, Macdonald, Peter S. and Davidson, Patricia M.. (2015). The caregiver role in thromboprophylaxis management in atrial fibrillation : A literature review. European Journal of Cardiovascular Nursing. 14(2), pp. 98-107. https://doi.org/10.1177/1474515114547647
A qualitative study of senior hospital managers' views on current and innovative strategies to improve hand hygiene
McInnes, Elizabeth, Phillips, Rosemary, Middleton, Sandy and Gould, Dinah. (2014). A qualitative study of senior hospital managers' views on current and innovative strategies to improve hand hygiene. BMC Infectious Diseases. 14, p. Article 611. https://doi.org/10.1186/s12879-014-0611-3
Atrial fibrillation : Stroke prevention in focus
Ferguson, Caleb, Inglis, Sally C., Newton, Phillip J., Middleton, Sandy, Macdonald, Peter S. and Davidson, Patricia M.. (2014). Atrial fibrillation : Stroke prevention in focus. Australian Critical Care. 27(2), pp. 92-98. https://doi.org/10.1016/j.aucc.2013.08.002
Health service management study for stroke : A randomized controlled trial to evaluate two models of stroke care
Chan, Daniel K.Y., Levi, Chris, Cordato, Dennis, O'Rourke, Fintan, Chen, Jack, Redmond, Helen, Xu, Ying-Hua, Middleton, Sandy, Pollack, Michael and Hankey, Graeme. (2014). Health service management study for stroke : A randomized controlled trial to evaluate two models of stroke care. International Journal of Stroke. 9(4), pp. 400-405. https://doi.org/10.1111/ijs.12240
Management of fever, hyperglycemia, and swallowing dysfunction following hospital admission for acute stroke in New South Wales, Australia
Drury, Peta, Levi, Christopher, McInnes, Elizabeth, Hardy, Jennifer, Ward, Jeanette, Grimshaw, Jeremy M., D'Este, Catherine, Dale, Simeon, McElduff, Patrick, Cheung, N. Wah, Quinn, Clare, Griffiths, Rhonda, Evans, Malcolm, Cadilhac, Dominique and Middleton, Sandy. (2014). Management of fever, hyperglycemia, and swallowing dysfunction following hospital admission for acute stroke in New South Wales, Australia. International Journal of Stroke. 9(1), pp. 23-31. https://doi.org/10.1111/ijs.12194
Thrombolysis ImPlementation in Stroke (TIPS) : Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care
Paul, Christine L., Levi, Christopher R., D'Este, Catherine, Parsons, Mark W., Bladin, Christopher F., Lindley, Richard I., Attia, John R., Henskens, Frans, Lalor, Erin, Longworth, Mark, Middleton, Sandy, Ryan, Annika, Kerr, Erin, Sanson-Fisher, Robert W. and Thrombolysis ImPlementation in Stroke (TIPS) Study Group. (2014). Thrombolysis ImPlementation in Stroke (TIPS) : Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care. Implementation Science. 9, p. Article 38. https://doi.org/10.1186/1748-5908-9-38
Quality in Acute Stroke Care (QASC) : Process evaluation of an intervention to improve the management of fever, hyperglycaemia and swallowing dysfunction following acute stroke
Drury, Peta, Levi, Christopher, D'Este, Catherine, McElduff, Patrick, McInnes, Elizabeth, Hardy, Jennifer, Dale, Simeon, Cheung, N. Wah, Grimshaw, Jeremy M., Quinn, Clare, Ward, Jeanette, Evans, Malcolm, Cadilhac, Dominique, Griffiths, Rhonda and Middleton, Sandy. (2014). Quality in Acute Stroke Care (QASC) : Process evaluation of an intervention to improve the management of fever, hyperglycaemia and swallowing dysfunction following acute stroke. International Journal of Stroke. 9(6), pp. 766-776. https://doi.org/10.1111/ijs.12202
Evaluation of the implementation of a bowel management protocol in intensive care : Effect on clinical practices and patient outcomes
Knowles, Serena, McInnes, Elizabeth, Elliott, Doug, Hardy, Jennifer and Middleton, Sandy. (2014). Evaluation of the implementation of a bowel management protocol in intensive care : Effect on clinical practices and patient outcomes. Journal of Clinical Nursing. 23(5-6), pp. 716-730. https://doi.org/10.1111/jocn.12448
Educational outreach visits to improve nurses' use of mechanical venous thromboembolism prevention in hospitalized medical patients
Duff, Jed, Walker, Kim, Abdulla, Omari, Middleton, Sandy and McInnes, Elizabeth. (2013). Educational outreach visits to improve nurses' use of mechanical venous thromboembolism prevention in hospitalized medical patients. Journal of Vascular Nursing. 31(4), pp. 139-149. https://doi.org/10.1016/j.jvn.2013.04.002
Educational outreach visits to improve venous thromboembolism prevention in hospitalised medical patients : A prospective before-and-after intervention study
Duff, Jed, Omari, Abdulla, Middleton, Sandy, McInnes, Elizabeth and Walker, Kim. (2013). Educational outreach visits to improve venous thromboembolism prevention in hospitalised medical patients : A prospective before-and-after intervention study. BMC Health Services Research. 13, p. Article 398. https://doi.org/10.1186/1472-6963-13-398
Development and interrater reliability testing of a telephone interview training programme for Australian nurse interviewers
Ahern, Tracey, Gardner, Anne, Gardner, Glenn, Middleton, Sandy and Della, Phillip. (2013). Development and interrater reliability testing of a telephone interview training programme for Australian nurse interviewers. Nurse Education Today. 33(5), pp. 470-474. https://doi.org/10.1016/j.nedt.2012.05.001
Atrial fibrillation and thromboprophylaxis in heart failure : The need for patient-centered approaches to address adherence
Ferguson, Caleb, Inglis, Sally C., Newton, Phillip J., Middleton, Sandy, Macdonald, Peter S. and Davidson, Patricia M.. (2013). Atrial fibrillation and thromboprophylaxis in heart failure : The need for patient-centered approaches to address adherence. Vascular Health and Risk Management. 9, pp. 3-11. https://doi.org/10.2147/VHRM.S39571
Comprehensive stroke units : A review of comparative evidence and experience
Chan, Daniel K. Y., Cordato, Dennis, O'Rourke, Fintan, Chan, Daniel L., Pollack, Michael, Middleton, Sandy and Levi, Chris. (2013). Comprehensive stroke units : A review of comparative evidence and experience. International Journal of Stroke. 8(4), pp. 260-264. https://doi.org/10.1111/j.1747-4949.2012.00850.x
Clinical guidelines for acute stroke management : Which recommendations should remain consensus-based?
Middleton, Sandy, Rowley, Julianne, Hillege, Sharon, Hill, Kelvin, Churilov, Leonid and Allnutt, Nissa. (2013). Clinical guidelines for acute stroke management : Which recommendations should remain consensus-based? Journal of Vascular Nursing. 31(2), pp. 72-83. https://doi.org/10.1016/j.jvn.2012.10.001
What people say about travelling outdoors after their stroke : A qualitative study
Barnsley, Lara, McCluskey, Annie and Middleton, Sandy. (2012). What people say about travelling outdoors after their stroke : A qualitative study. Australian Occupational Therapy Journal. 59, pp. 71-78. https://doi.org/10.1111/j.1440-1630.2011.00935.x
Stroke clinicians' priorities for stroke research
Lannin, Natasha, Ada, Louise, Lindley, Richard, Longworth, Mark, McCluskey, Annie and Middleton, Sandy. (2012). Stroke clinicians' priorities for stroke research. The Internet Iournal of Allied Health Sciences and Practice. 10(4), pp. 1-8. https://doi.org/10.46743/1540-580X/2012.1419
Care of patients with a diagnosis of chronic obstructive pulmonary disease : A cluster randomised controlled trial
Zwar, Nicholas A., Hermitz, Oshana, Comino, Elizabeth, Middleton, Sandy, Vagholkar, Sanjyot, Xuan, Wei, Wilson, Stephen and Marks, Guy B.. (2012). Care of patients with a diagnosis of chronic obstructive pulmonary disease : A cluster randomised controlled trial. Medical Journal of Australia. 197(7), pp. 394-398. https://doi.org/10.5694/mja12.10813
Stroke management : Updated recommendations for treatment along the care continuum
Wright, L., Hill, K. M., Bernhardt, J., Lindley, R., Ada, L., Bajorek, B. V., Barber, P. A., Beer, C., Golledge, J., Gustafsson, L., Hersh, D., Kenardy, J., Perry, L., Middleton, S., Brauer, S. G. and Nelson, M. R.. (2012). Stroke management : Updated recommendations for treatment along the care continuum. Internal Medicine Journal. 42(5), pp. 562-569. https://doi.org/10.1111/j.1445-5994.2012.02774.x
A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams : Study Protocol
Bunker, Jeremy M., Reddel, Helen K., Dennis, Sarah M., Middleton, Sandy, Van Schayck, CP, Crockett, Alan J., Hasan, Iqbal, Hermiz, Oshana, Vagholkar, Sanjyot, Marks, Guy B. and Zwar, Nicholas A.. (2012). A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams : Study Protocol. Implementation Science. 7(1), pp. 1 - 10. https://doi.org/10.1186/1748-5908-7-83
A qualitative study of stakeholder views of the conditions for and outcomes of successful clinical networks
McInnes, Elizabeth, Middleton, Sandy, Gardner, Glenn, Haines, Mary, Haertsch, Maggie, Paul, Christine L. and Castaldi, Peter. (2012). A qualitative study of stakeholder views of the conditions for and outcomes of successful clinical networks. BMC Health Services Research. 12(1), p. Article 49. https://doi.org/10.1186/1472-6963-12-49
Determinants of successful clinical networks : The conceptual framework and study protocol
Haines, Mary, Brown, Bernadette, Craig, Jonathan, D'Este, Catherine, Elliott, Elizabeth, Klineberg, Emily, McInnes, Elizabeth, Middleton, Sandy, Paul, Christine, Redman, Sally and Yano, Elizabeth M.. (2012). Determinants of successful clinical networks : The conceptual framework and study protocol. Implementation Science. 7(16), pp. 1-10. https://doi.org/10.1186/1748-5908-7-16
Peri-operative nurses' knowledge and reported practice of pressure injury risk assessment and prevention : A before-after intervention study
Sutherland-Fraser, Sally, McInnes, Elizabeth, Maher, Elisabeth and Middleton, Sandy. (2012). Peri-operative nurses' knowledge and reported practice of pressure injury risk assessment and prevention : A before-after intervention study. BMC Nursing. 11, p. Article 25. https://doi.org/10.1186/1472-6955-11-25
Preventing hypothermia in elective arthroscopic shoulder surgery patients : A protocol for a randomised controlled trial
Duff, Jed, di Staso, Renatta, Cobbe, Kerry-Anne, Draper, Nicole, Tan, Simon, Haliday, Emma, Middleton, Sandy, Lam, Lawerence and Walker, Kim. (2012). Preventing hypothermia in elective arthroscopic shoulder surgery patients : A protocol for a randomised controlled trial. BMC Surgery. 12(14), pp. 1-6. https://doi.org/10.1186/1471-2482-12-14
Improving quality of life by increasing outings after stroke : Study protocol for the Out-and-About trial
McClusky, Annie, Ada, Louise, Middleton, Sandy, Kelly, Patrick J., Goodall, Stephen, Grimshaw, Jeremy M., Logan, Pip, Longworth, Mark and Karageorge, A.. (2012). Improving quality of life by increasing outings after stroke : Study protocol for the Out-and-About trial. International Journal of Stroke. 8(1), pp. 54-58. https://doi.org/10.1111/j.1747-4949.2012.00966.x
An outcomes approach to stroke care : The importance of teamwork and evidence-based nursing care
Middleton, Sandy. (2012). An outcomes approach to stroke care : The importance of teamwork and evidence-based nursing care. International Journal of Stroke. 7(3), pp. 224-226. https://doi.org/10.1111/j.1747-4949.2012.00774.x
Predictors of accuracy of diagnosis of chronic obstructive pulmonary disease in general practice
Zwar, Nicholas A., Marks, Guy B., Hermiz, Oshana, Middleton, Sandy, Comino, Elizabeth J., Hasan, Iqbal, Vagholkar, Sanjyot and Wilson, Stephen F.. (2011). Predictors of accuracy of diagnosis of chronic obstructive pulmonary disease in general practice. Medical Journal of Australia. 195(4), pp. 168-171. https://doi.org/10.5694/j.1326-5377.2011.tb03271.x
An investigation of family carers' needs following stroke survivors' discharge from acute hospital care in Australia
Perry, Lin and Middleton, Sandy. (2011). An investigation of family carers' needs following stroke survivors' discharge from acute hospital care in Australia. Disability and Rehabilitation. 33(19-20), pp. 1890-1900. https://doi.org/10.3109/09638288.2011.553702
A study of 90-day outcomes for a cohort of patients admitted to an Australian metropolitan acute stroke unit
Jammali-Blasi, Asmara, McInnes, Elizabeth, Markus, Romesh, Faux, Steven, O'Loughlin, Grainne, Dale, Simeon and Middleton, Sandy. (2011). A study of 90-day outcomes for a cohort of patients admitted to an Australian metropolitan acute stroke unit. Journal of Vascular Nursing. 29(1), pp. 3-10. https://doi.org/10.1016/j.jvn.2010.11.004
Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC) : A cluster randomised controlled trial
Middleton, Sandy, McElduff, Patrick, Ward, Jeanette, Grimshaw, Jeremy M., Dale, Simeon, D'Este, Catherine, Drury, Peta, Griffiths, Rhonda, Cheung, N. Wah, Quinn, Clare, Evans, Malcolm, Cadilhac, Dominique and Levi, Christopher. (2011). Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC) : A cluster randomised controlled trial. The Lancet. 378(9804), pp. 1699-706. https://doi.org/10.1016/S0140-6736(11)61485-2
The status of Australian nurse practitioners: The second national census
Middleton, Sandy, Gardner, Anne, Gardner, G. and Della, P R.. (2011). The status of Australian nurse practitioners: The second national census. Australian Health Review. 35(4), pp. 448 - 454. https://doi.org/10.1071/AH10987
Death, dependency and health status 90 days following hospital admission for acute stroke in NSW
Middleton, S., Levi, C., Ward, J., Grimshaw, J., Griffiths, R., D'Este, C., Dale, S., Quinn, C., Evans, M., Cadilhac, D. and McElduff, P.. (2011). Death, dependency and health status 90 days following hospital admission for acute stroke in NSW. Internal Medicine Journal. 41(10), pp. 736-743. https://doi.org/10.1111/j.1445-5994.2010.02330.x
Continence management in acute stroke : A survey of current practices in Australia
Jordan, Louise-Anne, Mackey, Elizabeth, Coughlan, Kelly, Wyer, Mary, Allnutt, Nissa and Middleton, Sandy. (2011). Continence management in acute stroke : A survey of current practices in Australia. Journal of Advanced Nursing. 67(1), pp. 94-104. https://doi.org/10.1111/j.1365-2648.2010.05480.x
Clinical guidelines for stroke management 2010
National Stroke Foundation and *Middleton, Sandy. (2010). Clinical guidelines for stroke management 2010 National Stroke Foundation.
Foreword
Middleton, Sandy. (2010). Foreword. In In Williams, Jane, Perry, Lin and Watkins, Caroline (Ed.). Acute stroke nursing pp. vii-xi Wiley-Blackwell.
A snapshot of Australian nurse practitioners' extended practice activities
Gardner, Glenn, Gardner, Anne, Middleton, Sandy, Della, Phillip and Doubrovsky, Anna. (2010). A snapshot of Australian nurse practitioners' extended practice activities. The Nurse Practitioner Series. 3(1), pp. 8-15.
Evaluation of a housing support program for people who are at risk of homelessness : Perspective of people who refer clients
Rose, McMaster,, Hawley, Rhonda, Fletcher, Terese, Gillett, Wendy, McDermott, Susan and Middleton, Sandy. (2010). Evaluation of a housing support program for people who are at risk of homelessness : Perspective of people who refer clients. Journal of Social Distress and the Homeless. 19(April), pp. 18-46. https://doi.org/10.1179/105307810805365080
The work of nurse practitioners
Gardner, Glenn, Gardner, Anne, Middleton, Sandy, Della, Phillip, Kain, Victoria and Doubrovsky, Anna. (2010). The work of nurse practitioners. Journal of Advanced Nursing. 66(10), pp. 2160-2169. https://doi.org/10.1111/j.1365-2648.2010.05379.x
The first Australian nurse practitioner census : A protocol to guide standardized collection of information about an emergent professional group
Middleton, Sandy, Gardner, Glenn, Gardner, Anne, Della, Phillip, Gibb, Michelle and Millar, Lynne. (2010). The first Australian nurse practitioner census : A protocol to guide standardized collection of information about an emergent professional group. International Journal of Nursing Practice. 16(5), pp. 517-524. https://doi.org/10.1111/j.1440-172X.2010.01877.x
Development and validation of a novel approach to work sampling : A study of work practitioner work patterns
Gardner, Glenn, Gardner, Anne, Middleton, Sandy, Gibb, Michelle, Della, Phillip and Duffield, Christine. (2010). Development and validation of a novel approach to work sampling : A study of work practitioner work patterns. Australian Journal of Advanced Nursing. 27(4), pp. 4-12.
Setting stroke research priorities : The consumer perspective
Sangvatanakul, Pukkaporn, Hillege, Sharon, Lalor, Erin, Levi, Christopher, Hill, Kelvin and Middleton, Sandy. (2010). Setting stroke research priorities : The consumer perspective. Journal of Vascular Nursing. 28(4), pp. 121-131. https://doi.org/10.1016/j.jvn.2010.09.001
Patient care guidelines : A telephone survey of intensive care practices in New South Wales
Knowles, Serena, Rolls, Kaye, Elliott, Doug, Hardy, Jennifer and Middleton, Sandy. (2010). Patient care guidelines : A telephone survey of intensive care practices in New South Wales. Australian Critical Care. 23(1), pp. 21-29. https://doi.org/10.1016/j.aucc.2009.10.001
Increasing delivery of an outdoor journey intervention to people with stroke : A feasibility study involving five community rehabilitation teams
McCluskey, Annie and Middleton, Sandy. (2010). Increasing delivery of an outdoor journey intervention to people with stroke : A feasibility study involving five community rehabilitation teams. Implementation Science. 5, p. Article 59. https://doi.org/10.1186/1748-5908-5-59
Clients' understanding of the role of nurse practitioners
Susan, Allnutt,, Allnutt, Nissa, McMaster, Rose, O'Connell, Jane, Middleton, Sandy, Hillege, Sharon, Della, Phillip R., Gardner, Glenn E. and Gardner, Anne. (2010). Clients' understanding of the role of nurse practitioners. Australian Health Review. 34(1), pp. 59-65. https://doi.org/10.1071/AH09688
Nurses report a healthy culture : Results of the Practice Environment Scale (Australia) in an Australian hospital seeking magnet recognition
Walker, Kim, Middleton, Sandy, Rolley, John and Duff, Jed. (2010). Nurses report a healthy culture : Results of the Practice Environment Scale (Australia) in an Australian hospital seeking magnet recognition. International Journal of Nursing Practice. 16(6), pp. 616-623. https://doi.org/10.1111/j.1440-172X.2010.01890.x
Protocol and pilot data for establishing the Australian Stroke Clinical Registry
Cadihac, Dominique A., Lannin, Natasha A., Anderson, Craig S., Levi, Christopher R., Faux, Steven, Price, Chris, Middleton, Sandy, Lim, Joyce, Thrift, Amanda G. and Donnan, Geoffrey. (2010). Protocol and pilot data for establishing the Australian Stroke Clinical Registry. International Journal of Stroke. 5(3), pp. 217-226. https://doi.org/10.1111/j.1747-4949.2010.00430.x
Delivering an evidence-based outdoor journey intervention to people with stroke : Barriers and enablers experienced by community rehabilitation teams
McCluskey, Annie and Middleton, Sandy. (2010). Delivering an evidence-based outdoor journey intervention to people with stroke : Barriers and enablers experienced by community rehabilitation teams. BMC Health Services Research. 10, p. Article 18. https://doi.org/10.1186/1472-6963-10-18
The status of Australian nurse practitioners : The first national census
Gardner, Anne, Della, Phillip R., Middleton, Sandy and Gardner, Glenn. (2009). The status of Australian nurse practitioners : The first national census. Australian Health Review. 33(4), pp. 679-689. https://doi.org/10.1071/AH090679
Why fellowship? Peak professional bodies, peer recognition and credentialing in Australia
Middleton, Sandy, Walker, Kim and Leigh, Trina. (2009). Why fellowship? Peak professional bodies, peer recognition and credentialing in Australia. Collegian. 16(4), pp. 177-183. https://doi.org/10.1016/j.colegn.2009.06.002
Implementing clinical guidelines for acute stroke management : Do nurses have a lead role?
Hill, Kelvin, Middleton, Sandy, O'Brien, Elizabeth and Lalor, Erin. (2009). Implementing clinical guidelines for acute stroke management : Do nurses have a lead role? Australian Journal of Advanced Nursing. 26(3), pp. 53-58.
Fever, hyperglycaemia and swallowing dysfunction management in acute stroke : A cluster randomised controlled trial of knowledge transfer
Middleton, Sandy, Levi, Christopher, Ward, Jeanette, Grimshaw, Jeremy, Griffiths, Rhonda, D'Este, Catherine, Dale, Simeon, Cheung, N. Wah, Quinn, Clare, Evans, Malcolm and Cadihac, Dominique. (2009). Fever, hyperglycaemia and swallowing dysfunction management in acute stroke : A cluster randomised controlled trial of knowledge transfer. Implementation Science. 4, p. Article 16. https://doi.org/10.1186/1748-5908-4-16
The management of non-valvular atrial fibrillation (NVAF) in Australian general practice : Bridging the evidence-practice gap. A national representative postal survey
Gatellari, Melina, Worthington, John, Zwar, Nicholas A. and Middleton, Sandy. (2008). The management of non-valvular atrial fibrillation (NVAF) in Australian general practice : Bridging the evidence-practice gap. A national representative postal survey. BMC Family Practice. 9, p. Article 62. https://doi.org/10.1186/1471-2296-9-62
Nursing practice environment : How does one Australian hospital compare with magnet hospitals?
Middleton, Sandy, Griffiths, Rhonda, Fernandez, Ritin and Smith, Bronwyn. (2008). Nursing practice environment : How does one Australian hospital compare with magnet hospitals? International Journal of Nursing Practice. 14(5), pp. 366-372. https://doi.org/10.1111/j.1440-172X.2008.00708.x
A cluster randomised controlled trial of nurse and GP partnership for care of Chronic Obstructive Pulmonary Disease
Zwar, Nicholas, Hermiz, Oshana, Hasan, Iqbal, Comino, Elizabeth, Middleton, Sandy, Vagholkar, Sanjyot and Marks, Guy. (2008). A cluster randomised controlled trial of nurse and GP partnership for care of Chronic Obstructive Pulmonary Disease. BMC Pulmonary Medicine. 8, p. Article 8. https://doi.org/10.1186/1471-2466-8-8
Barriers to the use of anticoagulation for nonvalvular atrial fibrillation : A representative survey of Australian family physicians
Gatellari, Melina, Worthington, John, Zwar, Nicholas and Middleton, Sandy. (2008). Barriers to the use of anticoagulation for nonvalvular atrial fibrillation : A representative survey of Australian family physicians. Stroke. 39(1), pp. 227-230. https://doi.org/10.1161/STROKEAHA.107.495036
Identifying measures for evaluating new models of nursing care : A survey of NSW nurse practitioners
Middleton, Sandy, Allnutt, Susan, Griffiths, R., McMaster, Rose, O'Connell, Jane and Hillege, Sharon. (2007). Identifying measures for evaluating new models of nursing care : A survey of NSW nurse practitioners. International Journal of Nursing Practice. 13(6), pp. 331-340. https://doi.org/10.1111/j.1440-172X.2007.00647.x
Reviewing recommendations of root cause analyses
Middleton, Sandy, Chapman, Barbara, Griffiths, Rhonda and Chester, Rosemary. (2007). Reviewing recommendations of root cause analyses. Australian Health Review. 31(2), pp. 288-295. https://doi.org/10.1071/AH070288
Audit or research? Should nurse practitioners participate in these types of evaluation and what is the difference between them?
Middleton, Sandy. (2007). Audit or research? Should nurse practitioners participate in these types of evaluation and what is the difference between them? The Nurse Practitioner Series. 2(1), pp. 26-32.
Assessing surgeons' disclosure of risk information before carotid endarterrctomy
Middleton, Sandy, Gatellari, Melina, Harris, John P. and Ward, Jeanette E.. (2006). Assessing surgeons' disclosure of risk information before carotid endarterrctomy. ANZ Journal of Surgery. 76(7), pp. 618-624. https://doi.org/10.1111/j.1445-2197.2006.03788.x
Implementing root cause analysis in an area health service : Views of the participants
Middleton, Sandy, Walker, Carol and Chester, Rosemary. (2005). Implementing root cause analysis in an area health service : Views of the participants. Australian Health Review. 29(4), pp. 422-428. https://doi.org/10.1071/AH050422
Nursing intervention after carotid endarterectomy : A randomized trial of co-ordinated care post discharge (CCPD)
Middleton, Sandy, Donnelly, Neil, Harris, John and Ward, Jeanette. (2005). Nursing intervention after carotid endarterectomy : A randomized trial of co-ordinated care post discharge (CCPD). Journal of Advanced Nursing. 52(3), pp. 250-261. https://doi.org/10.1111/j.1365-2648.2005.03587.x
Effective discharge policy : Are we getting there?
Middleton, Sandy, Appleberg, Michael, Girgis, Seham and Ward, Jeanette E.. (2004). Effective discharge policy : Are we getting there? Australian Health Review. 28(3), pp. 255-259. https://doi.org/10.1071/AH040255
Improving stroke outcomes in Australia : A study of GP perspectives
Middleton, Sandy, Harris, John P., Sharpe, David M., Corbett, Alastair J., Lusby, Robert J. and Ward, Jeanette E.. (2004). Improving stroke outcomes in Australia : A study of GP perspectives. Australian Journal of Primary Health. 10(2), pp. 21-28. https://doi.org/10.1071/PY04022
Contamination of interventional research is possible through GP membership of more than one division
Middleton, Sandy and Ward, Jeanette. (2003). Contamination of interventional research is possible through GP membership of more than one division. Australian Family Physician. 32(1-2), pp. 95-96.
GP's views of quality initiatives to improve stroke outcomes following CEA
Middleton, Sandy, Harris, John, Lusby, Robert and Ward, Jeanette. (2003). GP's views of quality initiatives to improve stroke outcomes following CEA. Australian Family Physician. 32(10), pp. 858-861.
Vascular disease risk factor management four years after carotid endarterectomy : Are opportunities missed?
Middleton, Sandy, Harris, John, Lusby, R. and Ward, Jeanette. (2003). Vascular disease risk factor management four years after carotid endarterectomy : Are opportunities missed? ANZ Journal of Surgery. 73(4), pp. 225-231. https://doi.org/10.1046/j.1445-1433.2002.02570.x
Case scenarios to assess Australian general practitioners' understanding of stroke diagnosis, management and prevention
Middleton, Sandy, Sharpe, David, Harris, John, Corbett, Alastair, Lusby, Robert and Ward, Jeanette. (2003). Case scenarios to assess Australian general practitioners' understanding of stroke diagnosis, management and prevention. Stroke. 34(11), pp. 2681-2686. https://doi.org/10.1161/01.STR.0000096209.04460.BB