Querying Stroke Unit Nursing Interventions in the Emergency Department

Herlev Hospital

Status: Unknown

Conditions: TIA; Stroke

Treatments: Behavioral: Dedicated stroke nurse care in ED

Study type: Observational

Funder types: Other

Identifiers

NCT04011514

H-17035544

Details and patient eligibility

About

The aim of the study is to monitor if specialized stroke nurses as team partners in the ED can reduce hospital acquired infections. The study is designed as pre- post-intervention study in which specialized SU nurses partner with ED nursing staff to asses and screen stroke admissions in the ED.

Full description

An intervention study comprised of 1) a primary registry database component and 2) a secondary questionnaire based quantitative evaluation . The intervention study includes a 3-month baseline observational period followed by a 7-month baseline data collection period, a 2-month intervention implementation phase, and a 3-month intervention observational period followed by 7-month intervention data collection period.

An intervention, where dedicated stroke nurses handle acute care of stroke and TIA patient in the ED prior to admission to a dedicated stroke unit will take place in the timeframe of 11-19:00 hrs, 7 days a week. Notably, the intervention is set to be integrated into clinical practice on a permanent basis after end of study.

Data for all stroke patients admitted to the ED at HGH are collected during the 3-month baseline and intervention observational periods. Fulfilment of Danish Stroke Quality Program (DAP) quality indicators is monitored as follows - use of dysphagia screen (GUSS), mobilization within day of ED admission and transfer to SU. Additional nursing interventions monitored in the ED are: Use of nasogastric catheter, use of bladder scan and intermittent catheterization, frequency of temperature monitoring and use of anti-pyretics, acute phase monitoring of blood-pressure every 2 hours, use of Scandinavian Stroke Scale (SSS) score.

Outcomes are monitored in hospital and at visits to the out patient clinic, as well as by registry.

Enrollment: 800 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients referred to the ED at Herlev Hospital with a diagnosis of stroke or TIA from 11 Am to 7 PM
• patients fulfilling one of the following ICD-10 codes at discharge: ICH: I61, cerebral infarction; I63, unspecified: I64, TIA: G45 and a scheduled follow-up appointment at the outpatient clinic Herlev Hospital

Exclusion criteria

• Patients transferred from other hospitals or stroke units
• Patients elegible for thrombolysis or thrombectomy at time of admission

Trial design

800 participants in 2 patient groups

Baseline period

Description:

Usual care. Stroke patients admitted to the ED during the 3-month baseline inclusion period.

Treatment:

Behavioral: Dedicated stroke nurse care in ED

Intervention period

Description:

Intervention: 2 month implementation period of specialized stroke nurses allocated to ED for nurse specific treatment of stroke patients specific observations and care

Treatment:

Behavioral: Dedicated stroke nurse care in ED