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An outcomes approach to stroke care: the importance of teamwork and evidence-based nursing care


  • Sandy Middleton

  • Conflict of interest: None declared.

Correspondence: Sandy Middleton, National Centre for Clinical Outcomes Research, Australian Catholic University and Nursing Research Institute, St Vincent's & Mater Health Sydney, Executive Suite Level 5, DeLacy Building, St Vincent's Hospital, Victoria Rd, Darlinghurst 2010, NSW, Australia.



The Quality in Acute Stroke Care (QASC) was a cluster randomised control trial (CRCT) which evaluated the effectiveness of evidence-based clinical treatment protocols for the management of fever, hyperglycaemia and swallowing, in conjunction with multidisciplinary team building workshops, and a standardised interactive staff education program (collectively known as the Fever, Sugar, Swallowing (FeSS) intervention) to improve patient outcomes 90-days. We found that patients cared for in stroke units who received our intervention were 15·7% more likely to be alive and independent 90 days following their stroke. They also had significantly: fewer episodes of fever, lower mean temperatures, lower mean blood glucose levels, and better screening for swallowing difficulties.