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

澳大利亚国家中风单位计划最新的急性中风指南和建议支持对急性中风患者的发烧、血糖和吞咽进行及时和循证治疗。本聚类随机对照试验（CRCT）将开发并严格评估一种标准化的多学科团队建设干预措施，用于管理急性卒中后患者的发烧、血糖和吞咽。干预措施包括：循证临床治疗途径（FeSS途径）和基于设施的支持，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。分配给对照组的卒中单位将只接受FeSS通路，没有基于设施的支持。预期的患者结果包括：出院时残疾、住院时间、90天残疾、90天依赖、90天死亡和残疾以及分配到卒中干预单位接受治疗的患者90天健康状况的改善。此外，将进行医疗记录审计，以衡量FeSS途径吸收的完整性。通过开展CRCT，我们将为标准化、多学科团队建设干预在急性中风患者发烧、血糖和吞咽管理方面的有效性提供2级证据。因此，这项试验在澳大利亚和国际上都具有重要意义。

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.