Acute Stroke Units in Austria Are Being Set Up on a National Level Following Evidence-Based Recommendations and Structural Quality Criteria

Abstract Objective This study aimed to describe registered nurses’ (RNs) experiences of providing respiratory care in relation to hospital acquired pneumonia (HAP), specifically among patients with acute stroke being cared for at in-patient stroke units. Background One of the most common and serious respiratory complications associated with acute stroke is HAP. Respiratory care is among the fundamentals of patient care, and thus competency in this field is expected as part of nursing training. However, there is a paucity of literature detailing RNs’ experiences with respiratory care in relation to HAP, specifically among patients with acute stroke, in the context of stroke units. As such, there is a need to expand the knowledge base relating to respiratory care focusing on HAP, to assist with evidence-based nursing. Design A qualitative descriptive study. Method Eleven RNs working in four different acute stroke units in Southern Sweden participated in the current study. The data were collected through semi-structured interviews, and the transcribed interviews were analysed using inductive content analysis. Results Three overarching categories were identified: (1), awareness of risk assessments and risk factors for HAP (2) targeting HAP through multiple nursing care actions, and (3) challenges in providing respiratory care to patients in risk of HAP. These reflected the similarities and differences in the experiences that RNs had with providing respiratory care in relation to HAP among in-patients with acute stroke. Conclusions The findings from this study suggest that the RNs experience organisational challenges in providing respiratory care for HAP among patients with acute stroke. Respiratory care plays a vital role in the identification and prevention of HAP, but our findings imply that RNs’ knowledge needs to be improved, the fundamentals of nursing care need to be prioritised, and evidence-based guidelines must be implemented. RNs would also benefit from further education and support, in order to lead point-of-care nursing in multidisciplinary stroke teams.

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PP033-SUN ENSURING OPTIMAL NUTRITION IN ACUTE STROKE UNITS – DEVELOPMENT OF AN EVIDENCE-BASED NATIONAL PRACTICE GUIDELINE

Clinical Nutrition Supplements ◽

10.1016/s1744-1161(12)70085-6 ◽

2012 ◽

Vol 7 (1) ◽

pp. 38

Author(s):

M. Karaliute ◽

M.T. Børvik ◽

H. Nilssen ◽

I. Rasmussen ◽

B. Skille ◽

...

Keyword(s):

Acute Stroke ◽

Practice Guideline ◽

Evidence Based ◽

Stroke Units ◽

National Practice

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Abstract 115: Current Status of Acute Stroke Management in Korea: A Nationwide Report Based on 19,608 Patients Treated in 216 Hospitals

Stroke ◽

10.1161/str.51.suppl_1.115 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Jun Yup Kim ◽

Keon-Joo Lee ◽

Jihoon Kang ◽

Beom Joon Kim ◽

Seong-Eun Kim ◽

...

Keyword(s):

Acute Stroke ◽

Stroke Unit ◽

National Level ◽

Stroke Care ◽

Current Status ◽

Endovascular Coiling ◽

Stroke Management ◽

Acute Stroke Care ◽

Survey Period ◽

Stroke Units

Introduction: There have been few reports on status of acute stroke management at a national level worldwide, and none in Korea. This study is aimed to describe the current status and disparities of acute stroke management in Korea. Methods: Data from 5th (2013) and 6th (2014) national surveys for assessing quality of acute stroke care were used. Patients with principal diagnosis codes indicating subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), ischemic stroke (IS), who were admitted via emergency rooms within 7 days of onset at hospitals treating 10 or more stroke cases during the each 3-month survey period were selected. Results: A total of 19,608 stroke cases (age, 67.7±13.5years; female, 45%; IS, 76%; ICH, 15%; SAH, 9%) treated in 216 hospitals were analyzed. Thirty-one percent of hospitals had stroke units and 41% of stroke cases were treated at hospitals without stroke units. In IS, IV thrombolysis (IVT) and endovascular treatment (EVT) rates were 10.7% and 3.6%, respectively. Thirty-nine percent of IVT and fifty-two percent of EVT cases were performed in hospitals with annual volume of <25 IVT and <15 EVT. Centralization of EVT showed disparities by region (Figure). Carotid endarterectomy, carotid artery stenting, decompressive, bypass surgery was conducted in 0.2%, 1.4%, 1.0%, 0.2% of IS cases; decompressive surgery was done in 28.1% of ICH cases; surgical clipping, endovascular coiling was done in 17.2%, 14.3% of SAH cases, respectively. There were noticeable regional disparities in various interventions, use of ambulance, arrival time and provision of stroke unit service. Conclusions: This study is the first report on the status of acute stroke care in Korea on a national level. Large number of recanalization therapies were performed in low-volume-hospitals. Expansion of stroke unit service, stroke center certification or accreditation, and connections between stroke centers and EMS are highly recommended.

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New evidence-based A1, A2, A3 alarm time zones for transferring thrombolysed patients to hyper-acute stroke units: faster is better

Neurological Sciences ◽

10.1007/s10072-019-03901-8 ◽

2019 ◽

Vol 40 (8) ◽

pp. 1659-1665 ◽

Cited By ~ 3

Author(s):

Thang S. Han ◽

Giosue Gulli ◽

Brendan Affley ◽

David Fluck ◽

Christopher H. Fry ◽

...

Keyword(s):

Acute Stroke ◽

Evidence Based ◽

Stroke Units ◽

Time Zones ◽

New Evidence

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Faculty Opinions recommendation of Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13399002.14858058 ◽

2012 ◽

Author(s):

Shyam Prabhakaran ◽

Laurel J Smit

Keyword(s):

Randomised Controlled Trial ◽

Acute Stroke ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Evidence Based ◽

Treatment Protocols ◽

Evidence Based Treatment ◽

Cluster Randomised ◽

Swallowing Dysfunction ◽

Randomised Controlled

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We Are All Environmentalists! Framing Life in the National Green Tribunal, India

Journal of Developing Societies ◽

10.1177/0169796x211001229 ◽

2021 ◽

pp. 0169796X2110012

Author(s):

Sudha Vasan

Keyword(s):

National Level ◽

Himachal Pradesh ◽

Indigenous Community ◽

Environmental Laws ◽

Set Up ◽

Power Project

India has set up one of the first national-level legal bodies, the National Green Tribunal (NGT), dedicated exclusively to address cases under environmental laws. My research follows a case filed in the NGT by an indigenous community against a hydel power project in the western Himalayan state of Himachal Pradesh, examining how diverse and opposing parties in this case represent themselves as environmentalists. It reveals a narrative sphere where entirely opposite actions and actors are legitimated in and through the NGT in environmental terms. This article suggests that green courts provoke green narratives and examines how diverse actors respond and engage with this demand. Individuals are interpellated in this juridical field to understand and present themselves as environmentalists. Environment is a meta-narrative in this juridical field, constituting environmentalist subjectivity of all actors within this field by the very process of hailing them.

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Eye Protection in ENT Practice During the COVID-19 Pandemic

OTO Open ◽

10.1177/2473974x211010408 ◽

2021 ◽

Vol 5 (2) ◽

pp. 2473974X2110104

Author(s):

Jia Hui Ng ◽

Dan Daniel ◽

Anton Sadovoy ◽

Constance Ee Hoon Teo

Keyword(s):

Health Care ◽

Protective Equipment ◽

Evidence Based ◽

Clinical Scenario ◽

Degree Of Contamination ◽

Eye Protection ◽

Fluorescent Microscope ◽

Set Up ◽

Evidence Based Guidelines ◽

Care Worker

Objectives There is a lack of evidence-based guidelines with regard to eye protection for aerosol-generating procedures in otolaryngology practice. In addition, some recommended personal protective equipment (PPE) is not compatible with commonly used ENT equipment. This study aims to investigate the degree of eye protection that commonly used PPE gives. Study Design Simulation model. Setting Simulation laboratory. Methods A custom-built setup was utilized to simulate the clinical scenario of a patient cough in proximity of a health care worker. A system that sprays a xanthan-fluorescein mixture was set up and calibrated to simulate a human cough. A mannequin with cellulose paper placed on its forehead, eyes, and mouth was fitted with various PPE combinations and exposed to the simulated cough. The degree of contamination on the cellulose papers was quantified with a fluorescent microscope able to detect aerosols ≥10 µm. Results When no eye protection was worn, 278 droplets/aerosols reached the eye area. The use of the surgical mask with an attached upward-facing shield alone resulted in only 2 droplets/aerosols reaching the eye area. In this experiment, safety glasses and goggles performed equally, as the addition of either brought the number of droplets/aerosols reaching the eye down to 0. Conclusion When used with an upward-facing face shield, there was no difference in the eye protection rendered by safety goggles or glasses in this study. Safety glasses may be considered a viable alternative to safety goggles in aerosol-generating procedures.

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