Fever, Hyperglycemia, and Swallowing Management in Stroke Unit and Non–Stroke-Unit European Hospitals : A Quality in Acute Stroke Care (QASC) Europe Substudy
Journal article
Ding, Ranran, Betihavas, Vasiliki, McElduff, Benjamin, Dale, Simeon, Coughlan, Kelly, McInnes, Elizabeth Catherine, Middleton, Sandra Jane and Fasugba, Oyebola. (2024). Fever, Hyperglycemia, and Swallowing Management in Stroke Unit and Non–Stroke-Unit European Hospitals : A Quality in Acute Stroke Care (QASC) Europe Substudy. Journal of Neuroscience Nursing. 56(2), pp. 42-48. https://doi.org/10.1097/JNN.0000000000000743
Authors | Ding, Ranran, Betihavas, Vasiliki, McElduff, Benjamin, Dale, Simeon, Coughlan, Kelly, McInnes, Elizabeth Catherine, Middleton, Sandra Jane and Fasugba, Oyebola |
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Abstract | Stroke unit care reduces patient morbidity and mortality. The Quality in Acute Stroke Care Europe Study achieved significant large-scale translation of nurse-initiated protocols to manage Fever, hyperglycemia (Sugar), and Swallowing (FeSS) in 64 hospitals across 17 European countries. However, not all hospitals had stroke units. Our study aimed to compare FeSS protocol adherence in stroke unit versus non–stroke-unit hospitals. METHODS: An observational study using Quality in Acute Stroke Care Europe Study postimplementation data was undertaken. Hospitals were categorized using 4 evidence-based characteristics for defining a stroke unit, collected from an organizational survey of participating hospitals. Differences in FeSS Protocol adherence between stroke unit and non–stroke-unit hospitals were investigated using mixed-effects logistic regression, adjusting for age, sex, and National Institutes of Health Stroke Scale. RESULTS: Of the 56 hospitals from 16 countries providing organizational data, 34 (61%) met all 4 stroke unit characteristics, contributing data for 1825 of 2871 patients (64%) (stroke unit hospitals). Of the remaining 22 hospitals (39%), 17 (77%) met 3 of the 4 stroke unit characteristics (non–stroke-unit hospitals). There were no differences between hospitals with a stroke unit and those without for postimplementation adherence to fever (49% stroke unit vs 57% non–stroke unit; odds ratio [OR], 0.400; 95% confidence interval [CI], 0.087-1.844; P = .240), hyperglycemia (50% stroke unit vs 57% non–stroke unit; OR, 0.403; 95% CI, 0.087–1.856; P = .243), swallowing (75% stroke unit vs 60% non–stroke unit; OR, 1.702; 95% CI, 0.643–4.502; P = .284), or overall FeSS Protocol adherence (36% stroke unit vs 36% non–stroke unit; OR, 0.466; 95% CI, 0.106–2.043; P = .311). CONCLUSION: Our results demonstrate that the nurse-initiated FeSS Protocols can be implemented by hospitals regardless of stroke unit status. This is noteworthy because hospitals without stroke unit resources that care for acute stroke patients can potentially implement these protocols. Further effort is needed to ensure better adherence to the FeSS Protocols. |
Keywords | dysphagia; FeSS; fever; hyperglycemia; implementation; QASC; stroke; stroke unit; swallow |
Year | 01 Jan 2024 |
Journal | Journal of Neuroscience Nursing |
Journal citation | 56 (2), pp. 42-48 |
Publisher | Lippincott Williams & Wilkins |
ISSN | 0888-0395 |
Digital Object Identifier (DOI) | https://doi.org/10.1097/JNN.0000000000000743 |
Web address (URL) | https://journals.lww.com/jnnonline/abstract/2024/04000/fever,_hyperglycemia,_and_swallowing_management_in.4.aspx |
Open access | Published as non-open access |
Research or scholarly | Research |
Page range | 42-48 |
Publisher's version | |
Output status | Published |
Publication dates | |
Apr 2024 | |
Online | 07 Dec 2023 |
Publication process dates | |
Deposited | 05 Sep 2024 |
Additional information | Copyright © 2023, Copyright © 2023 American Association of Neuroscience Nurses |
Place of publication | United States |
https://acuresearchbank.acu.edu.au/item/90y03/fever-hyperglycemia-and-swallowing-management-in-stroke-unit-and-non-stroke-unit-european-hospitals-a-quality-in-acute-stroke-care-qasc-europe-substudy
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