Improving stroke Emergency Department nursing care: The Code Stroke 2.0 pre-test/post-test feasibility study

BackgroundActivation of an acute ‘Code Stroke’ pathway on hospital arrival improves thrombolysis rates. Whilst post-stroke protocols to manage fever, hyperglycaemia, and dysphagia (Fever, Sugar Swallow (FeSS) Protocols) have been shown reduce death dependency, facilitated implementation in Emergency Department (ED) has difficult.AimTo evaluate if expanded role for Acute Stroke Nurse Code activation, increases FeSS Protocol uptake ED, results faster stroke unit transfer.MethodsA pre-test/post-test feasibility study undertaken Australian ED. Intervention comprised who instigated care or supported ED clinicians use the protocols. Logistic regression analyses compared outcomes intervention. Subgroup analysis examined intervention effect during business hours.FindingsThere were 117 patients each pre-intervention post-intervention cohorts (n = 234). Post-intervention had significantly more activations (pre: 7%, post: 62%), temperature at 62%, 78%), formal blood glucose 55%, 98%), fewer oral medications administered before swallow screening 31%, 14%), transfers within 4 h from 26%, 41%), 53%, 80%). hours showed significant improvement 10%, 79%), testing 57%, reduced 24%, 9%), 45%, 82%).ConclusionExpanding support staff was associated with improved processes. Our findings highlight potential successful this model across multiple hospitals improve patient outcomes.