Improving Coordination and Transitions of Care in Stroke Patients

University of Pennsylvania

Status: Completed

Conditions: Stroke; Transient Ischemic Attack

Treatments: Other: Nursing care model

Study type: Interventional

Funder types: Other

Identifiers

NCT02642744

823366

Details and patient eligibility

About

This study will examine if the attending nurse model will enhance critical patient-centered elements of care that will in turn improve patient education and shared decision-making, medication adherence, stroke-related health literacy, and reduce early readmissions to ultimately yield improved patient quality of life. Our primary objective is to determine whether the attending nurse model of care improves stroke patients' health at 7 days, 30 days, and 90 days after hospital discharge as assessed through questionnaires.

Enrollment: 670 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• > 18 years of age
• Admission to the Hospital of the University of Pennsylvania Vascular Neurology service
• Incident or recurrent:
• Ischemic stroke: focal neurological deficit of likely ischemic vascular origin
• Intracerebral hemorrhage: blood seen on initial head CT
• Transient Ischemic attack: focal neurological deficit of likely ischemic vascular origin that has clinically resolved

Exclusion criteria

• Pregnancy
• Comfort or hospice care
• Severe dementia prior to stroke
• Non-communicative and have no family/social support

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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670 participants in 2 patient groups

Attending nurse model

Other group

Description:

The attending nurse model of in-hospital care delivery aims to improve patient understanding, shared decision making, medication adherence, and reduce early readmissions after discharge to improve quality of life. On the inpatient stroke unit, the attending nurse will take ownership of essential aspects of an individual stroke patient's care, education, and transition out of the hospital. To further contribute to the patient's plan of care, the attending nurse will be present on daily teaching rounds.

Treatment:

Other: Nursing care model

Conventional inpatient nursing care

No Intervention group

Description:

Standard of care nursing care patients receive while inpatient