How well are fever, hyperglycaemia and swallowing managed post-stroke across europe baseline results from the quality in acute stroke care (QASC) Europe project.

Background and Aims: The Quality in Acute Stroke (QASC) trial demonstrated a significant reduction in death and disability when clinicians were assisted to introduce protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following stroke. A unique international collaboration between the Nursing Research Institute, Australian Catholic University; the European Stroke Organisation; and the Angels Initiative is underway to implement the FeSS Protocols into 20 European countries. We present baseline (pre-FeSS implementation) results for management of these important physiological parameters post-stroke Methods: Data were entered into the European Registry of Stroke Care Quality (RES-Q) for 7 indicators of FeSS care between 2017-2019. Result(s): Forty hospitals from 13 countries completed baseline data entry (n=2266 patients). Paracetamol was administered within one hour following temperature >37.5degreeC C for 58% of patients (n=214/367). When glucose was >10mmols/L, 60% of patients (n=241/403) received insulin within one hour. 57% of patients (1293/2266) received a swallow screen or assessment before being given oral food, fluids or medications. Conclusion(s): All FeSS processes of care need improving, and we are actively working with the Angels Initiative and clinicians to implement the FeSS protocols which have been translated into 13 different languages. Successful large-scale implementation of these evidence-based, nurse-initiated protocols into countries with vastly different health care systems, many of whom also have no access to reperfusion therapies, is likely to make a significant impact on reducing death and disability after stroke.