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Table 3 Adherence to composite outcome and individual FeSS processes (2013–2017)

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

FeSS monitoring and treatment processes

Univariable

Multivariable

2013,N = 3741,n (%)

2015,N = 4087,n (%)

2017,N = 4192,n (%)

2013a–2015,OR (95% CI)

2013a–2017,OR (95% CI)

2015a–2017,OR (95% CI)

Individual FeSS processes

      

 Fever treatment

      

  Paracetamol within 1 hb, c

192 (36)

186 (39)

226 (49)

1.1 (0.85, 1.5)

1.7 (1.3, 2.2)

1.5 (1.1, 2.0)

  Overall fever treatmentb

3099 (90)

3800 (93)

3952 (94)

1.4 (1.2, 1.7)

1.7 (1.5, 2.1)

1.2 (1.0, 1.5)

 Hyperglycaemia treatment

      

  Insulin within 1 hb

160 (25)

204 (29)

256 (38)

1.3 (0.97, 1.6)

2.0 (1.5, 2.5)

1.6 (1.2, 2.0)

  Overall hyperglycaemia treatmentb

2947 (86)

3579 (88)

3781 (90)

1.2 (1.0, 1.3)

1.5 (1.3, 1.8)

1.3 (1.1, 1.5)

 Swallow monitoring

      

  Swallow screen OR assessment within 24 h of hospital admission

2310 (62)

2618 (64)

2884 (69)

1.2 (1.1, 1.3)

1.5 (1.3, 1.6)

1.3 (1.1, 1.4)

  Swallow screen or assessment before food or drink

1875 (50)

2222 (54)

2600 (62)

1.2 (1.1, 1.4)

1.7 (1.6, 1.9)

1.4 (1.3, 1.5)

  Swallow screen or assessment before oral medications

1687 (45)

2047 (50)

2420 (58)

1.3 (1.1, 1.4)

1.8 (1.6, 1.9)

1.4 (1.3, 1.5)

  Overall swallow monitoring

1401 (37)

1621 (40)

2059 (49)

1.2 (1.1, 1.3)

1.8 (1.6, 1.9)

1.5 (1.4, 1.7)

 Swallow treatment

      

  Assessed by speech pathologist if failed swallow screen

562 (96)

769 (97)

826 (95)

1.3 (0.74, 2.3)

0.83 (0.50, 1.4)

0.64 (0.38, 1.1)

  Swallow treatmentd

3716 (99)

4061 (99)

4149 (99)

1.0 (0.58, 1.8)

0.62 (0.38, 1.1)

0.62 (0.38, 1.1)

 Swallow monitoring and treatment

1387 (37)

1599 (39)

2027 (48)

1.1 (1.0, 1.3)

1.7 (1.6, 1.9)

1.5 (1.4, 1.7)

Composite outcome

      

 All elements of fever, sugar, swallow dysfunction monitored and treated

1024 (30)†

1290 (32)

1731 (41)

1.1 (1.0, 1.2)

1.8 (1.6, 2.0)

1.6 (1.4, 1.8)

  1. Dependent variable in multivariable analyses is adherence to FeSS processes; independent variable is year, adjusted for correlation within hospital. Italicised results are significant
  2. FeSS fever, sugar, swallow; OR odds ratio; CI confidence interval
  3. aYear used as reference for multivariable analyses
  4. bExcludes patients receiving palliative care in 2013
  5. cIn 2015/2017, those contraindicated to and already receiving regular paracetamol included as ‘no’ in denominator
  6. dAssessed by speech pathologist if failed swallow screen—those who passed or did not receive swallow screen were considered to have received appropriate treatment
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Implementation Science

ISSN: 1748-5908