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Apr 19, 2019

ESOC-2019

“QASC EUROPE” THE FIRST RESULTS OF THE STUDY IN ITALY: COMPARATIVE ANALYSIS OF THE DATA OBTAINED FROM THE OBSERVATIONAL STUDY OF TWO DIFFERENT HOSPITALS

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Introduction Approximately 15 million people worldwide suffer a stroke each year. There is compelling evidence that improved patient outcomes are achieved through early intervention in acute stroke care, including thrombolysis, endovascular clot retrieval and access to specialised in-patient stroke units. Hyperglycaemia, swallowing dysfunction and elevated temperature are physiological variables known to be associated with poorer stroke outcomes. Optimal management of fever, hyperglycaemia and dysphagia have been identified in international guidelines as priorities for inpatient stroke management. The Quality in Acute Stroke Care (QASC) Trial, has shown, in the countries where the study was conducted, that multidisciplinary nurse-led interventions to manage fever, hyperglycaemia and swallow difficulties following acute stroke, significantly improved health outcomes. Results showed that supported implementation of the Fever, Sugar, Swallow (FeSS) Clinical Protocols resulted in 16% decreased death and dependency at 90-days, and in-hospital: reduced mean temperatures, reduced mean glucose levels and improved swallow screening management. There also was a non-significant reduction in length of stay by two days. Results were fast-tracked for publication in The Lancet, with a commentary, having won the Canadian Stroke Congress Award for Impact in 2011 and the 2012 American Heart Association Council on Cardiovascular Nursing Stroke Article of the year. The Italian study was conducted at the San Camillo Forlanini Hospital in Rome and at the Hospital of Avezzano, which are two very different hospitals for localization and approach to the Stroke. Method We proceeded, as envisaged by the International Protocol QASC, to the first phase of the study, which is the observational study, with the audit of 42 patient records of patients hospitalized in the two Centers during 2018 with diagnosis of acceptance of the ICD 10. For the cases at provisional intervals (six months) we will proceed to a new audit entitled "Clinical Results of Treatment Processes" and we will verify the implementation of the protocol by measuring body temperature every 4-6 hours for the first 72 hours, together with a possible treatment. Blood glucose measurements will be performed every 4-6 hours in the first 72 hours and any treatment steps will begin. The ability to swallow in the first 24 hours from admission will be evaluated and the speech therapy will be provided, depending on the case. The objective of the study is to compare the data obtained with the comparison of the two observational studies, with the data of the literature, to evaluate the different outcomes in terms of survival, disability, from a first comparison of the Stroke patient's approach. and reduction of hospitalization days. Results From the analysis of the data it is evident that the approach of the nursing staff to the patient with stroke is very different in the two Centers. While at the Hospital of Avezzano great attention is paid to the detection and management of fever and glycemia, at San Camillo Forlanini Hospital nurses are much more attentive to swallowing disorders secondary to a stroke. Discussion and Conclusions These results demonstrate the importance of nationwide adoption of nursing protocols that recalculate treatment inequalities and base nursing care on scientific evidence, to reduce complications and increase the benefits for stroke victims in Italy

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© Copyright 2019 Morressier GmbH.
All rights reserved.