CRCT of a multidisciplinary, team building intervention to manage Fever, Sugar and Swallowing (FeSS) in Acute Stroke

澳大利亚国家卒中单元计划的最新急性卒中指南和建议支持对急性卒中的发烧、血糖和吞咽进行迅速和循证的治疗。这项群集化随机对照试验(CRCT)将开发并严格评估标准化、多学科团队建设干预措施，以管理急性中风患者的发热、血糖和吞咽。干预措施包括：循证临床治疗路径(FESS路径)和以设施为基础的支持，包括多学科、团队建设研讨会、标准化的互动教育计划以及通过支持和反馈让当地工作人员参与。分配给控制组的卒中单位将只接受FESS路径，没有基于设施的支持。预期的患者结局包括减少：出院残疾、住院时间、90天残疾、90天抚养、90天死亡和残疾，以及那些被分配到干预卒中单元接受护理的患者更高的90天健康状况。此外，将进行医疗记录审计，以衡量FESS途径摄取的完整性。通过进行CRCT，我们将产生二级证据，证明标准化的、多学科的团队建设干预措施在管理急性中风患者的发热、血糖和吞咽方面的有效性。因此，这项试验在澳大利亚国内和国际上都具有非常重要的意义。

The latest acute stroke guidelines and recommendations from Ausralia's National Stroke Unit Program endorse a prompt and evidence-based treatment for fever, blood sugar and swallowing in acute stroke. This Clustered Randomised Control Trial (CRCT) will develop and rigorously evaluate a standardised, multidisciplinary team-building intervention for the management of fever, blood sugar and swallowing in patients following acute stroke. The intervention comprises: an evidence-based clinical treatment pathway (the FeSS Pathway) and facility-based support consisting of multidisciplinary, team building workshops, a standardised, interactive education program and engagement of local staff through support and feedback. Stroke Units allocated to the control group will receive only the FeSS Pathway with no facility-based support. Expected patient outcomes comprise decreased: disability on discharge, length of stay, 90-day disability, 90-day dependency, 90-day death and disability and higher 90-day health status for those patients allocated to receive care at intervention Stroke Units. Further, medical record audits will be undertaken to measure the integrity of the FeSS Pathway uptake. By conducting a CRCT, we will generate Level 2 evidence for the effectiveness of a standardised, multidisciplinary team-building intervention for the management of fever, blood sugar and swallowing in patients following acute stroke. Thus, this trial is highly significant both within Australia and internationally.