The program is led by the Director of Nursing Research Institute Professor Sandy Middleton and Clinical Research Fellow Simeon Dale and is based at St Vincent’s Hospital in Sydney. The research is ably supported by fellow team members Professor Elizabeth McInnes, Kelly Coughlan, Cintia Martinez, Tara Doyle, Joylynn Israel, Patty Zenonos and Benjamin Mcelduff.

The award recognises the impact that the QASC program has had in improving the care and outcomes experienced by stroke patients, both in Australia and overseas, over the past decade.

At the heart of the program is the implementation of nursing protocols that foster optimal management of fever, raised blood glucose levels and swallowing difficulties in stroke patients over the first 72 hours after hospital admission.

Professor Sandy Middleton said stroke is one of the leading causes of disability in Australia and improved nursing practices can reduce the risk of long-term harm.

“This can mean the difference for someone being able to return to their home after a stroke rather than having to move into a nursing home,” Professor Middleton said.

The initial QASC trial, published in 2011, supported the introduction of the nurse-led protocols into 19 Acute Stroke Units in NSW. It resulted in a 16 per cent reduction in patient death and dependency within the first 90 days after a stroke. A follow-up study found that four years on, these trial patients were 20 per cent less likely to have died than other stroke patients.

Sandy said the 2011 trial was the first study internationally to provide evidence of the link between stroke nursing care and reduced death and dependency.

The trial’s success was supported by best-practice behaviour change methods which saw Simeon working with nursing staff at each site to discuss barriers for implementing the protocols, what may need to be adapted, and to create local champions for the project.

“If you can facilitate discussion amongst people and help them to come to their own solutions, that is a lot more empowering and likely to support effective change than just telling them what to do,” Simeon said.


Due to the trial’s success, the team then partnered with the NSW Agency for Clinical Innovation (ACI) to roll-out the protocols to all 36 NSW stroke services.

The team were then contacted by the European Stroke Organisation who wished to implement the protocols in hospitals in 14 European countries working with the Angels Initiative – each with different health care systems and some in impoverished regions.

“To think that we could sit in our office here in Australia and influence clinical practice in Europe was pretty bold.” Sandy said.

Yet the team took on the challenge and Sandy said it was rewarding to see how European nurses have developed new skills as a result of working with QASC.

“One nurse from the Czech Republic had never done a quality improvement study before - which is standard practice for Australian nurses. She won an award for her work and continues to advocate to have the protocols used more broadly in her country,” she said.

Simeon said being involved in the QASC program was helping some European hospitals to understand the importance of data collection for improving health care.

“For some it’s the first time they’ve collected data, let alone data about what nurses are doing.” she said.

Simeon and Sandy said it was wonderful to have both the body of work and the work of the whole research team acknowledged through the Vice-Chancellor’s Staff Excellence Awards.

“These projects are not something that we’ve done overnight, each one is a little piece of the jigsaw puzzle that we’ve slotted in over the past ten years, and there’s been a tremendous amount of support from the whole team,” Sandy said.

The team continues to receive interest in use of the protocols from around the world and hopes to attract further funding to respond to these needs.

“We want to take on the world!” Simeon said.

Page last updated on 05/04/2020

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