QASC Implementation Project (2012-2013)

The Quality in Acute Stroke Care (QASC) Trial showed that multidisciplinary, evidence-based, nurse-led interventions to manage fever, hyperglycaemia and swallowing following stroke significantly improved outcomes. Results, published in the Lancet, demonstrated that supported implementation of Fever, Sugar, and Swallow  (FeSS) Protocols decreased 90-day death and dependency by 16% (p=0.002), reduced in-hospital temperatures over the first 72 hours (p=0.001), glucose levels (p=0.02), improved swallowing management (p=<0.001), and had a clinically-important two-day length of stay reduction even though this was not statistically significant (p>0.144).¹

Partnering with the New South Wales Agency for Clinical Innovation and the Stroke Foundation, we were tasked to ‘scale-up and spread’ the QASC program to all 36 stroke services in New South Wales. Using a pre-test/ post-test study design, we significantly increased the proportion of patients who received care according to the FeSS Protocols.²