ASSESSING ORGANISATIONAL CONTEXT IN EMERGENCY DEPARTMENTS PRIOR TO IMPLEMENTING EVIDENCE-BASED STROKE CARE PROTOCOLS – THE T3 TRIAL CONTEXT ANALYSIS

5 days of antibiotic for uncomplicated pneumonia is enough: the non-inferiority results of the SAFER RCT The most important guidelines for the treatment of community-acquired pneumonia (CAP) indicate amoxicillin as the drug of first choice, however there is a lack of evidence-based indications about the duration of this therapy. This study conducted in 2 emergency departments in Canada randomized 281 children aged 6 months to 10 years with CAP without the need for hospitalization to treatment with high-dose amoxicillin for 5 days versus a traditional 10 day therapy. In terms of clinical recovery, both groups presented comparable results. In fact, the “per protocol” analysis, recommended for a “non-inferiority” design, did not formally provide this result. The exclusively clinical recruitment criteria (any investigations were optional), well reflect the reality of primary care, and the results, albeit with some limitations, suggest that in uncomplicated CAP, brief therapy should be considered in the guidelines.

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Acute stroke care in non-urban emergency departments

Neurology ◽

10.1212/wnl.57.11.2006 ◽

2001 ◽

Vol 57 (11) ◽

pp. 2006-2012 ◽

Cited By ~ 41

Author(s):

W.S. Burgin ◽

L. Staub ◽

W. Chan ◽

T.H. Wein ◽

R.A. Felberg ◽

...

Keyword(s):

Acute Stroke ◽

Emergency Departments ◽

Stroke Care ◽

Acute Stroke Care

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Abstract P849: Effects of Standardized Stroke Protocols on Nursing Confidence and Knowledge in Low Volume Telestroke Emergency Departments

Stroke ◽

10.1161/str.52.suppl_1.p849 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Michelle Provencher ◽

Stephen A Figueroa ◽

Robin Novakovic ◽

Linda Hynan ◽

Daiwai M Olson ◽

...

Keyword(s):

Nursing Education ◽

Acute Stroke ◽

Emergency Departments ◽

Intervention Group ◽

Stroke Care ◽

Controlled Study ◽

Workflow Model ◽

Acute Stroke Care ◽

Post Intervention ◽

Care Protocol

Introduction: Nurses and staff in Emergency Departments (ED) with low monthly case volumes have few opportunities to build confidence and solidify skills in acute stroke management. The Nursing-driven Acute Stroke Care (NAS-Care) study tested a workflow model with empowerment of ED bedside nurses, clear role assignments for team members, and standardized protocols including a predefined run sheet. Methods: Seven Texas hospitals participated in this prospective, multisite, baseline-controlled study as part of the Lone Star Stroke Research Consortium. After three months of blinded baseline data collection, the following interventions were implemented: NIHSS certification, nursing education including mock stroke codes, and a standardized flowsheet for code organization and documentation (run sheet). Participating nurses were surveyed before and after implementation of this process. Results: The study was completed at 6 hospitals, with 180 patients in the pre-intervention group and 267 in the post-intervention group. The study intervention was found to improve Door-to-ED provider and Door-to-CT metrics but not physician-dependent metrics, Door-to-Needle or Door-to-Provider times (Provencher et al, ISC 2020). Completed surveys were returned by 97 nurses (pre-intervention) and 57 nurses (post-intervention). There were significant increases in the following questions (10 point scale, p<.001): “I understand goals and processes of stroke code activation”, “stroke codes at my institution are completed efficiently”, and “stroke codes are nursing-driven.” In the post-intervention surveys, nurses reported that the NAS-Care protocol improved understanding (mean score 8.0 +/- 2.4 SD/10) and efficiency (8.2 +/- 2.4/10), and reported that they would recommend NAS-Care to be adopted at other institutions (8.8 +/- 2.1/10). Conclusion: Standardized nurse-driven stroke protocols improved self-assessed knowledge and confidence for nurses in EDs utilizing telestroke, in addition to gains in staff-dependent stroke metrics.

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Rehabilitation Therapists’ Clinical Questions in the Context of Evidence-Based Patient Care: An Exploratory Study

Proceedings of the Annual Conference of CAIS / Actes du congrès annuel de l'ACSI ◽

10.29173/cais774 ◽

2013 ◽

Author(s):

Lorie Kloda ◽

Joan Bartlett

Keyword(s):

Qualitative Study ◽

Patient Care ◽

Exploratory Study ◽

Occupational Therapists ◽

Stroke Care ◽

Evidence Based ◽

Speech Language Pathologists ◽

Accident Vasculaire Cérébral ◽

Clinical Questions ◽

Etude Qualitative

In this qualitative study, rehabilitation therapists (occupational therapists, physiotherapists, and speech-language pathologists) working in stroke care will be asked about their clinical questions. The goals of the study are: to identify common characteristics of questions, to develop a typology of questions, and to uncover reasons why certain questions are pursued.Pour cette étude qualitative, des thérapeutes en réadaptation (ergothérapeutes, physiothérapeutes et orthophonistes) œuvrant auprès de patients ayant subi un accident vasculaire cérébral sont interrogés à propos de leurs questions cliniques. Cette étude vise à déterminer les caractéristiques communes des questions, à dresser une typologie des questions et à découvrir les raisons pour lesquelles certaines questions adressées.

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