Background:
The Quality in Acute Stroke Care (QASC) Trial demonstrated that when stroke units were supported to implement protocols to manage Fever, hyperglycaemia (Sugar) and Swallowing (FeSS) post-stroke there was a reduction in death and disability. Subsequently, FeSS has been incorporated in national guidelines, and, since July 2019 has been available as an optional dataset in the Australian Stroke Clinical Registry (AuSCR).
Aim:
To evaluate voluntary uptake of the optional FeSS dataset in AuSCR since its inception in July 2019.
Methods:
Descriptive analysis of AuSCR data (1/07/2019-31/12/2023) from participating adult hospitals in Victoria, Tasmania, Queensland and South Australia.
Results:
In 2019, 24% (17/71) of hospitals contributed FeSS data for n=988 episodes. In 2023, this number had increased to 39% (24/61) for n=4737 episodes. The majority of these hospitals were from regional settings 14 (59%) and the remainder were from major cities. Adherence to individual FeSS variables had improved over time for all variables by 5-12% except for temperature monitoring on day one (reduced by 2%) and prompt treatment of BGL>10mmol/s with Insulin (reduced by 9%).
Conclusion:
There is strong interest from hospitals participating in AuSCR to routinely monitor FeSS variables during acute care. Reduced adherence to temperature monitoring may be related to the extended time patients spend in emergency departments where FeSS Protocols may not be in use. Although treatment with insulin for major episodes of hyperglycaemia remains suboptimal, improvements in adherence to all other FeSS variables over time is encouraging.