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Table 1 Comparison of processes collected in QASC, QASCIP and National Audits, with outline of FeSS processes included for analyses

From: Inclusion of a care bundle for fever, hyperglycaemia and swallow management in a National Audit for acute stroke: evidence of upscale and spread

 

Processes included in the FeSS protocols

QASC

QASCIP

National Audits

Processes included in the current study and definition foranalysis

2013

2015

2017

 

Fever

 

 Temperature recorded at least four times on day 1, day 2 and day 3a

×

×

 
 

 Received paracetamol within 1 h of the first febrile event (recorded in first 72 h)

F1

 Overall fever treatment

 

Patients without fever classified as receiving appropriate fever treatment

 

Hyperglycaemia

 

 Formal venous blood glucose level recorded in the ED

×

×

 
 

 Finger prick glucose recorded at least four times on day 1, day 2 and day 3a

×

×

 
 

 Insulin within 1 h if glucose > 10 mmol/Lb (recorded in the first 72 h)

G1

Overall hyperglycaemia treatment

     

Patients without high glucose classified as receiving appropriate hyperglycaemia treatment

 

Swallow

S1

 Swallow screen or swallow assessment by speech pathologist within 24 h of admission

S2

 Swallow screen or assessment before food or drink

S3

 Swallow screen or assessment before oral medications

S4

 Overall swallow monitoring

     

Met all of S1, S2 and S3 (total cohort)

S5

 Swallow assessment by speech pathologist if failed swallow screen

Those who did not fail swallow screen or did not receive the screen were classified as receiving appropriate swallow treatment

S6

 Overall swallow monitoring and treatment

     

If monitoring elements S1, S2, S3 and treatment element S5 all met

 

Composite outcome

All fever, sugar and swallow elements

     

Met all of F1, G1 and S6

  1. FeSS fever, sugar swallow; QASC Quality in Acute Stroke; QASCIP Quality in Acute Stroke Implementation Project; ED emergency department
  2. aQuestion was asked individually for each of day 1, day 2 and day 3
  3. bFinger prick glucose greater than 10 mmol/L (in QASC used 11 mmol/L, with changes reflecting recent updates in Australian guidelines)