Quality in Acute Stroke Care Program
The St Vincent’s Health Network and Australian Catholic University’s (ACU) Nursing Research Institute has led a 10-year program of translational research to implement protocols to manage fever, hyperglycaemia (‘sugar’) and swallowing (FeSS Protocols) in the first 72 hours following acute stroke.
Co-funded by the NHMRC, St Vincent’s Clinic Foundation and in-kind from ACU, our seminal trial demonstrated a 16% absolute reduction in death and dependency with facilitated implementation of these nurse-initiated protocols.1 This effect was sustained with over 20% of patients receiving care in the intervention stroke units more likely to be alive four years later.2 Working with the NSW Agency Clinical Innovation, we then implemented the FeSS Protocols into all 36 NSW stroke services3 winning 2014 Premiers Public Sector Award for Improving Performance and Accountability.
An independent economic evaluation has determined that use of the FeSS Protocols over five years would result in $65M savings in healthcare costs and $253M savings in societal costs.4 Recommendations for use of the FeSS Protocols have now been included in multiple stroke guidelines (Australia, UK, US, Lazio in Italy, Romania, and Kazakhstan (under consideration); including Australia.5 We recently partnered with the European Stroke Organisation; industry: the European Acute Networks Striving for Excellence in Stroke (Angels) Initiative; and the European Registry of Stroke Care Quality (RES-Q) and successfully achieved large-scale implementation of the FeSS Protocols into routine acute stroke care in 64 hospitals throughout 17 European countries (Armenia, Belarus, Bulgaria, Czech Republic, Georgia, Italy, Kazakhstan, Lithuania, Moldova, Poland, Portugal, Romania, Russia, Slovakia, Spain, Ukraine & Uzbekistan).6 This Australian-led program of clinical research has transformed stroke nursing practice internationally by introduction of these protocols into real-time, real-world clinical practice to improve patient outcomes.
It is an example of outstanding intra-precinct university-MRI-clinical collaboration.