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Emergency department stroke and transient ischaemic attack care bundle

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Background

Improving the management of acute stroke and transient ischaemic attack (TIA) in the emergency department (ED) was identified as a priority by the NICS emergency care community of practice (EC CoP).

In response, NICS initiated a project to develop a set of evidence-based resources to improve the implementation of guideline recommendations for acute stroke and TIA management in the ED.

The project used the National Stroke Foundation’s (NSF) Clinical Guidelines for Acute Stroke Management (2007), available from the NSF website, as the evidence-base for the resources. In addition to the NSF guidelines, another nine relevant, evidence-based guidelines were used to develop the ‘guideline summaries’ that are included in the resource (see Appendix B below).

Given the ED setting and the varied requirements of acute stroke management, a care bundle approach was selected to prioritise the core relevant NSF recommendations for implementation.

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What is a care bundle?

A care bundle is defined as a group of several simple, specific but non-prescriptive, evidence based components that, when combined, define best care and significantly improve patient outcomes. Please see the Information and implementation package for more information about care bundles.

According to the Institute for Healthcare Improvement, developers of the care bundle concept, for a care bundle to be effective, each component included in a bundle must also satisfy the following criteria:

  • each component must be based on sound evidence
  • the delivery of each component must be in need of improvement
  • to deliver each component must be achievable in terms of resources
  • no component should be a major source of controversy
  • and the delivery of each component must be measurable

The care bundle approach is designed to be easily achievable and sustainable both to implement and to audit.

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Emergency department stroke and TIA care bundle

Information and implementation package

A comprehensive master document, developed to fully explain the care bundle itself and provide implementation information.

This document has been designed for the individual implementing the care bundle in their organisation (the project lead) and therefore aims to be comprehensive, but still practical.

Summary for clinicians

A summary document which includes all the necessary and practical information taken from the Implementation and information package.

Poster

An A3 format poster for use in the Emergency Department as a reminder to staff.

Education Presentation

A presentation developed to be used by the project lead as part of implementation of the care bundle.

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Further information

Printed copies of the clinician summary and poster are available for order from NHMRC publications.

For further information, please email emergencycare@nhmrc.gov.au.

Endorsing agencies

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Page last reviewed: 6 January 2010