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Organised care of acute stroke at Groote Schuur Hospital : a controlled trial

Includes bibliographical references.

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Main Author: Patel, Nilesh-Kumar
Other Authors: Louw, Stephen
Format: Thesis
Language:English
Published: Department of Public Health and Family Medicine 2015
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access_status_str Open Access
author Patel, Nilesh-Kumar
author2 Louw, Stephen
author_browse Louw, Stephen
Patel, Nilesh-Kumar
author_facet Louw, Stephen
Patel, Nilesh-Kumar
author_sort Patel, Nilesh-Kumar
collection Thesis
description Includes bibliographical references.
format Thesis
id oai:open.uct.ac.za:11427/12314
institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:46:05.263Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2015
publishDateRange 2015
publishDateSort 2015
publisher Department of Public Health and Family Medicine
publisherStr Department of Public Health and Family Medicine
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/12314 Organised care of acute stroke at Groote Schuur Hospital : a controlled trial Patel, Nilesh-Kumar Louw, Stephen Myers, Jonny Epidemiology Includes bibliographical references. Background and purpose: Groote Schuur Hospital (GSH) admits about 570 stroke patients annually. These patients about occupy 10% of acute medical beds. Recent investigations have demonstrated that stroke services are poorly organised Although "Organised stroke care" has been shown to improve outcomes, this has not been demonstrated locally. This study was undertaken to determine whether stroke unit care within a general medical ward improves outcomes. Study design and sampling: The study was a prospective non-randomised controlled trial, with systematic allocation by admission day. of all acute stroke admissions to the Department of Medicine from 1 January to 15 May 1996. Intervention: There were three comparison groups: in the Stroke Intervention Ward, the intervention was implemented by the author; in the Guidelines Ward, the manner in which the intervention can be set up and implemented was provided in the form of a Guidelines Booklet and in the Control Ward, stroke patients received routine care. The intervention consisted of (i) geographic/spatial unity and allocation of a designated nurse; (ii) use of a Stroke Clerking Pro forma and (iii) a multidisciplinary Team Care Plan and Post Intake Stroke Ward Round. Results: 58 patients were admitted to the Stroke Intervention Ward, 40 patients were admitted to the Guidelines Ward and 91 were admitted to the 2 Control Wards. The groups had similar baseline characteristics, except for the percentage of patients continent on admission. There were no significant differences in the Modified Barthel Index prior to admission, at discharge or at follow-up. There were no significant differences in the principal outcome measures (death, dependency, death or dependency, institutionalisation and death or institutionalisation) between the comparison groups. The median [inter-quartile range] length of hospital stay in days was significantly reduced in the Stroke Intervention Ward (6.5[5-9]) compared to the Guidelines Ward (9[7-14]) and the Control Wards (8[5-12]). The referral rates to Professionals Allied to Medicine were significantly increased in the Stroke Intervention Ward, except for referrals to the Community Liaison Sister. The referral rates to rehabilitation resources on discharge were significantly increased in the Stroke Intervention Ward, except for referrals to physiotherapy. Conclusions: Organised Stroke Care is feasible in our setting and results in improved utilisation of resources without increasing length of stay. However, principle outcome measures were not significantly altered in this study. 2015-01-27T09:37:00Z 2015-01-27T09:37:00Z 2000 Master Thesis Masters MPhil http://hdl.handle.net/11427/12314 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Epidemiology
Patel, Nilesh-Kumar
Organised care of acute stroke at Groote Schuur Hospital : a controlled trial
thesis_degree_str Master's
title Organised care of acute stroke at Groote Schuur Hospital : a controlled trial
title_full Organised care of acute stroke at Groote Schuur Hospital : a controlled trial
title_fullStr Organised care of acute stroke at Groote Schuur Hospital : a controlled trial
title_full_unstemmed Organised care of acute stroke at Groote Schuur Hospital : a controlled trial
title_short Organised care of acute stroke at Groote Schuur Hospital : a controlled trial
title_sort organised care of acute stroke at groote schuur hospital a controlled trial
topic Epidemiology
url http://hdl.handle.net/11427/12314
work_keys_str_mv AT patelnileshkumar organisedcareofacutestrokeatgrooteschuurhospitalacontrolledtrial