IND Case study World Stroke Day: Nurses Transforming Stroke Nursing Practice

Case Study Submitted by: Sandy Middleton, Professor
Country: Australia



1. Stroke Foundation. National Stroke Audit Acute Services Report. 2017. Stroke Foundation, Melbourne, Australia.

2. Middleton S, McElduff P, Ward J, Grimshaw J, Dale S, D’Este C, Drury P, Griffiths R, Cheung NW, Quinn C, Evans M, Cadilhac D, Levi C. Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia and swallowing dysfunction in acute stroke improves 90-day outcomes: QASC, a cluster randomised controlled trial. The Lancet 2011; 378(9804): 1699-1706.

3. Middleton S, Coughlan K, Mnatzaganian G, Choy N, Dale, S, Jammali-Blasi A, Levi C, Grimshaw J, Ward J, Cadilhac D, McElduff P, Hiller J, D’Este C. Mortality reduction for fever, hyperglycaemia and swallowing nurse-initiated stroke intervention: QASC trial follow-up. Stroke 2017; 48: 1331-1336.

4. Australian Clinical Trials Alliance. Economic evaluation of investigator-initiated clinical trials conducted by networks. Australian Commission on Safety and Quality in Healthcare 2017. Available from:

5. Middleton S, McElduff P, Drury P, D’Este C, Cadilhac DA, Dale S, Grimshaw J, Ward J, Quinn C, Cheung NW, Levi C. Vital sign monitoring following stroke associated with 90-day independence: a secondary analysis of the QASC cluster randomized trial. International Journal of Nursing Studies 2019; 89: 72-79

6. Middleton S, Lydtin A, Comerford D, Cadilhac DA, McElduff P, Dale S, Hill K, Longworth M, Ward J, Cheung NW, D’Este C on behalf of the QASCIP Working Group and Steering Committee. From QASC to QASCIP: successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pre-test/ post-test study design. BMJ Open 2016; 6(5): e011568.

7. Purvis T, Middleton S, Craig L, Kilkenny M, Dale S, Hill K, D’Este C, Cadilhac D. Inclusion of a care bundle for fever, hyperglycaemia, and swallow management in a National Audit for acute stroke: evidence of upscale and spread. Implementation Science 2019; 14:87.

8. Mikulik R, Ylikotila P, Roine R, Brozman M, Middleton S. Leaving a legacy of Stroke in Europe: A community of dedicated professionals is changing the face of stroke in Europe. Oruen – The CNS Journal 2017; 3(1): 8-18.

9. Government of South Australia, SA Health, Stroke Model of Care Oversight Committee. Stroke Management Procedures and Protocols V3.1; SA Health, Clinical Guideline No.: CG002 22 May 2019: 1-130.

10. Government of Western Australia, Department of Health. Training Centre in Subacute care. Western Australia Health Stroke Education Framework. V. 2.0; 14 March 2016: 1-24.

11. Stroke Foundation. Clinical Guidelines for Stroke Management. 2017, Stroke Foundation, Melbourne, Australia: 1-56.

12. Royal College of Physicians, National Clinical Guidelines for Stroke. Royal College of Physicians, United Kingdom, 5th Edition. 2016: 1-174.

13. The Society of Neurology in Romania. The Priority action for the interventional treatment of patients with acute stroke. 2018, Ministry of Health, Romania: 11

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