scholarly journals Barriers to evidence-based acute stroke care in Ghana: a qualitative study on the perspectives of stroke care professionals

BMJ Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. e015385 ◽  
Author(s):  
Leonard Baatiema ◽  
Ama de-Graft Aikins ◽  
Adem Sav ◽  
George Mnatzaganian ◽  
Carina K Y Chan ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Acute Stroke ◽  
Stroke Care ◽  
Evidence Based ◽  
Acute Stroke Care

Is the practice of goal-setting for patients in acute stroke care patient-centred and what factors influence this? A qualitative study

2015 ◽  
Vol 30 (5) ◽  
pp. 508-519 ◽  
Author(s):  
Sheeba Rosewilliam ◽  
Carron Sintler ◽  
Anand D Pandyan ◽  
John Skelton ◽  
Carolyn A Roskell
Keyword(s):  
Qualitative Study ◽  
Acute Stroke ◽  
Goal Setting ◽  
Stroke Care ◽  
Care Patient ◽  
Acute Stroke Care

International translation of Fever, Sugar, Swallow Protocols: The Quality in Acute Stroke Care Europe Project

2020 ◽  
Vol 15 (6) ◽  
pp. 591-594
Author(s):  
S Middleton ◽  
W Pfeilschifter
Keyword(s):  
Acute Stroke ◽  
International Collaboration ◽  
Stroke Care ◽  
Healthcare Systems ◽  
European Countries ◽  
Evidence Based ◽  
Acute Stroke Care ◽  
Catholic University ◽  
Preparation Phase ◽  
Evidence Based Nursing

The Quality in Acute Stroke (QASC) trial demonstrated a significant reduction in death and disability when clinicians were assisted to introduce protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following stroke. We describe a unique international collaboration between the Nursing Research Institute at Australian Catholic University; the European Stroke Organisation; and the Angels Initiative, working collaboratively to support implementation of the nurse-led FeSS Protocols in 20 European countries. We currently have 71 hospitals from 16 countries participating (hospitals from four countries are in the preparation phase) with 49 hospitals currently entering data (n=2819 patients to-date). Baseline data have been received from 39 hospitals, with FeSS Protocol implementation commenced at 16 hospitals. Five hospitals have completed the Project. 'Upscale and spread' of these evidence-based, nursing protocols into countries with vastly different healthcare systems, many of whom also have no access to the latest stroke therapies, is likely to make a significant impact in reducing death and disability after stroke.

scholarly journals Development and Implementation of Evidence-Based Indicators for Measuring Quality of Acute Stroke Care

Stroke ◽  
2006 ◽  
Vol 37 (10) ◽  
pp. 2573-2551 ◽  
Author(s):  
Peter U. Heuschmann ◽  
Marcel K. Biegler ◽  
Otto Busse ◽  
Susanne Elsner ◽  
Armin Grau ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Evidence Based ◽  
Acute Stroke Care

scholarly journals Patient‐centredness in acute stroke care – a qualitative study from the perspectives of patients, relatives and staff

2020 ◽  
Vol 27 (8) ◽  
pp. 1638-1646
Author(s):  
L. Busetto ◽  
C. Stang ◽  
J. Hoffmann ◽  
H. Amiri ◽  
F. Seker ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care ◽  
Patient Centredness

scholarly journals Health care providers’ perceptions of factors that influence the provision of acute stroke care in urban and rural settings: A qualitative study

2020 ◽  
Vol 8 ◽  
pp. 205031212092108
Author(s):  
Mitchell Dwyer ◽  
Gregory M. Peterson ◽  
Seana Gall ◽  
Karen Francis ◽  
Karen M. Ford
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Acute Stroke ◽  
Stroke Care ◽  
Rural Hospitals ◽  
Public Hospitals ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
Acute Stroke Care ◽  
Data Set

Objectives: Individuals living in rural areas have comparatively less access to acute stroke care than their urban counterparts. Understanding the local barriers and facilitators to the use of current best practice for acute stroke may inform efforts to reduce this disparity. Methods: A qualitative study featuring semi-structured interviews and focus groups was conducted in the Australian state of Tasmania. Clinical staff from a range of disciplines involved in acute stroke care were recruited from three of the state’s four major public hospitals (one urban and two rural). A semi-structured interview guide based on the findings of an earlier quantitative study was used to elicit discussion about the barriers and facilitators associated with providing acute stroke care. An inductive process of thematic analysis was then used to identify themes and subthemes across the data set. Results: Two focus groups and five individual interviews were conducted. Four major themes were identified from analysis of the data: systemic issues, clinician factors, additional support and patient-related factors. Acute stroke care within the study’s urban hospital was structured and comprehensive, aided by the hospital’s acute stroke unit and specialist nursing support. In contrast, care provided in the study’s rural hospitals was somewhat less comprehensive, and often constrained by an absence of infrastructure or poor access to existing resources. Conclusion: The identified factors help to characterise acute stroke care within urban and rural hospitals and will assist quality improvement efforts in Tasmania’s hospitals.

Towards evidence-based policies to strengthen acute stroke care in low-middle-income countries

2020 ◽  
Vol 418 ◽  
pp. 117117
Author(s):  
Leonard Baatiema ◽  
Seye Abimbola ◽  
Ama de-Graft Aikins ◽  
Albertino Damasceno ◽  
Andre Pascal Kengne ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Evidence Based ◽  
Acute Stroke Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

scholarly journals Association Between Adherence to Quality Indicators and 7-Day In-Hospital Mortality After Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3664-3672
Author(s):  
Kirsten Haas ◽  
Viktoria Rücker ◽  
Peter Hermanek ◽  
Björn Misselwitz ◽  
Klaus Berger ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Acute Stroke ◽  
Quality Indicators ◽  
Random Effect ◽  
Multivariable Analysis ◽  
Stroke Care ◽  
Evidence Based ◽  
Acute Stroke Care

Background and Purpose: Quality indicators (QI) are an accepted tool to measure performance of hospitals in routine care. We investigated the association between quality of acute stroke care defined by overall adherence to evidence-based QI and early outcome in German acute care hospitals. Methods: Patients with ischemic stroke admitted to one of the hospitals cooperating within the ADSR (German Stroke Register Study Group) were analyzed. The ADSR is a voluntary network of 9 regional stroke registers monitoring quality of acute stroke care across 736 hospitals in Germany. Quality of stroke care was defined by adherence to 11 evidence-based indicators of early processes of stroke care. The correlation between overall adherence to QI with outcome was investigated by assessing the association between 7-day in-hospital mortality with the proportion of QI fulfilled from the total number of QI the individual patient was eligible for. Generalized linear mixed model analysis was performed adjusted for the variables age, sex, National Institutes of Health Stroke Scale and living will and as random effect for the variable hospital. Results: Between 2015 and 2016, 388 012 patients with ischemic stroke were reported (median age 76 years, 52.4% male). Adherence to distinct QI ranged between 41.0% (thrombolysis in eligible patients) and 95.2% (early physiotherapy). Seven-day in-hospital mortality was 3.4%. The overall proportion of QI fulfilled was median 90% (interquartile range, 75%–100%). In multivariable analysis, a linear association between overall adherence to QI and 7-day in-hospital-mortality was observed (odds ratio adherence <50% versus 100%, 12.7 [95% CI, 11.8–13.7]; P <0.001). Conclusions: Higher quality of care measured by adherence to a set of evidence-based process QI for the early phase of stroke treatment was associated with lower in-hospital mortality.

scholarly journals A qualitative study of clinical champions in context: Clinical champions across three levels of acute care

2018 ◽  
Vol 6 ◽  
pp. 205031211879242 ◽  
Author(s):  
Mindy E Flanagan ◽  
Laurie Plue ◽  
Kristine K Miller ◽  
Arlene A Schmid ◽  
Laura Myers ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Acute Stroke ◽  
Stroke Care ◽  
Three Dimensions ◽  
Complex Care ◽  
Acute Stroke Care ◽  
Cross Sectional ◽  
Care Processes ◽  
Veterans Affairs Medical Centers ◽  
The Right

Objectives: To compare activities and field descriptions of clinical champions across three levels of stroke centers. Methods: A cross-sectional qualitative study using quota sampling was conducted. The setting for this study was 38 acute stroke centers based in US Veterans Affairs Medical Centers with 8 designated as Primary, 24 as Limited Hours, and 6 as Stroke Support Centers. Key informants involved in stroke care were interviewed using a semi-structured approach. A cross-case synthesis approach was used to conduct a qualitative analysis of clinical champions’ behaviors and characteristics. Clinical champion behaviors were described and categorized across three dimensions: enthusiasm, persistence, and involving the right people. Results: Clinical champions at Primary Stroke Centers represented diverse medical disciplines and departments (education, quality management); directed implementation of acute stroke care processes; coordinated processes across service lines; and benefited from supportive contexts for implementation. Clinical champions at Limited Hours Stroke Centers varied in steering implementation efforts, building collaboration across disciplines, and engaging in other clinical champion activities. Clinical champions at Stroke Support Centers were implementing limited changes to stroke care and exhibited few behaviors fitting the three clinical champion dimensions. Other clinical champion behaviors included educating colleagues, problem-solving, implementing new care pathways, monitoring progress, and standardizing processes. Conclusion: These data demonstrate clinical champion behaviors for implementing changes to complex care processes such as acute stroke care. Changes to complex care processes involved coordination among clinicians from multiple services lines, persistence facing obstacles to change, and enthusiasm for targeted practice changes.

Sign in / Sign up

Export Citation Format

Share Document