Stroke, Transient Ischemic Attack
Conditions
Brief summary
This study will examine if the attending nurse model will enhance critical patient-centered elements of care that will in turn improve patient education and shared decision-making, medication adherence, stroke-related health literacy, and reduce early readmissions to ultimately yield improved patient quality of life. Our primary objective is to determine whether the attending nurse model of care improves stroke patients' health at 7 days, 30 days, and 90 days after hospital discharge as assessed through questionnaires.
Interventions
OTHERNursing care model
Subjects will be randomized into either the attending nursing model of care vs the standard nursing model
Sponsors
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \> 18 years of age * Admission to the Hospital of the University of Pennsylvania Vascular Neurology service * Incident or recurrent: * Ischemic stroke: focal neurological deficit of likely ischemic vascular origin * Intracerebral hemorrhage: blood seen on initial head CT * Transient Ischemic attack: focal neurological deficit of likely ischemic vascular origin that has clinically resolved
Exclusion criteria
* Pregnancy * Comfort or hospice care * Severe dementia prior to stroke * Non-communicative and have no family/social support
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stroke Patient Education Retention Tool | 90 days | measures patient knowledge about stroke |
| Medication Compliance | 90 Days | medication adherence measurement |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Attending Nurse Model The attending nurse model of in-hospital care delivery aims to improve patient understanding, shared decision making, medication adherence, and reduce early readmissions after discharge to improve quality of life. On the inpatient stroke unit, the attending nurse will take ownership of essential aspects of an individual stroke patient's care, education, and transition out of the hospital. To further contribute to the patient's plan of care, the attending nurse will be present on daily teaching rounds.
Nursing care model: Subjects will be randomized into either the attending nursing model of care vs the standard nursing model | 129 |
| Conventional Inpatient Nursing Care Standard of care nursing care patients receive while inpatient | 169 |
| Total | 298 |
Baseline characteristics
| Characteristic | Attending Nurse Model | Conventional Inpatient Nursing Care | Total |
|---|---|---|---|
| Age, Continuous | 63 years STANDARD_DEVIATION 15 | 63 years STANDARD_DEVIATION 16 | 63 years STANDARD_DEVIATION 16 |
| Race/Ethnicity, Customized African American, Non-Hispanic | 57 Participants | 57 Participants | 114 Participants |
| Race/Ethnicity, Customized Asian | 2 Participants | 5 Participants | 7 Participants |
| Race/Ethnicity, Customized Missing | 1 Participants | 7 Participants | 8 Participants |
| Race/Ethnicity, Customized Other | 16 Participants | 23 Participants | 39 Participants |
| Race/Ethnicity, Customized White, Hispanic | 2 Participants | 3 Participants | 5 Participants |
| Race/Ethnicity, Customized White, Non-Hispanic | 51 Participants | 74 Participants | 125 Participants |
| Region of Enrollment United States | 129 participants | 169 participants | 298 participants |
| Sex: Female, Male Female | 54 Participants | 78 Participants | 132 Participants |
| Sex: Female, Male Male | 75 Participants | 91 Participants | 166 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 129 | 0 / 169 |
| other Total, other adverse events | 0 / 129 | 0 / 169 |
| serious Total, serious adverse events | 0 / 129 | 0 / 169 |
Outcome results
Primary
Medication Compliance
medication adherence measurement
Time frame: 90 Days
Population: These numbers reflect the number of participants that completed the measure
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Attending Nurse Model | Medication Compliance | Adherent | 53 Participants |
| Attending Nurse Model | Medication Compliance | Non-adherent | 29 Participants |
| Conventional Inpatient Nursing Care | Medication Compliance | Adherent | 67 Participants |
| Conventional Inpatient Nursing Care | Medication Compliance | Non-adherent | 27 Participants |
Primary
Stroke Patient Education Retention Tool
measures patient knowledge about stroke
Time frame: 90 days
Population: These numbers reflect the number of participants that completed the measure
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Attending Nurse Model | Stroke Patient Education Retention Tool | Good | 49 Participants |
| Attending Nurse Model | Stroke Patient Education Retention Tool | Bad | 29 Participants |
| Conventional Inpatient Nursing Care | Stroke Patient Education Retention Tool | Good | 52 Participants |
| Conventional Inpatient Nursing Care | Stroke Patient Education Retention Tool | Bad | 38 Participants |