Implementing and evaluating the Bridges Stroke Self-Management Programme into South Canterbury District Health Board stroke services.
- Conditions
- strokePhysical Medicine / Rehabilitation - Other physical medicine / rehabilitationStroke - HaemorrhagicStroke - Ischaemic
- Registration Number
- ACTRN12618001019291
- Lead Sponsor
- niversity of Otago
- Brief Summary
Aim: To evaluate implementation of the Bridges Stroke Self-Management Programme (Bridges) into a New Zealand District Health Board (DHB) stroke service. Design: A case study design with qualitative evaluation was used. Method: Participants were all staff involved in stroke care. We implemented Bridges via six ‘Plan Do Study Act’ cycles. Training involved two workshops separated by four months of supported implementation. Evaluative data were from surveys, focussed discussions, case reflections and qualitative interviews. Results: Of the 57 staff initially trained, 12 staff attended follow-up training and only six agreed to be interviewed. To accommodate shifts, nurses (n=18) had to be trained separately. Staff were supported in implementation by staff “Champions”, drop-in sessions, newsletters, posters, peer review observations, and a staff learning platform. Integrated data analysis identified that staff valued Bridges, but small patient numbers, lack of time and other competing initiatives, compounded by high staff turnover, limited full uptake. Some staff were able to transfer their learnings to patients with other conditions. There was however a shift in staff language towards prioritising self-management and to patient-centred goal setting. Conclusion: Staff endorsement resulted in greater awareness of self-management but limited full uptake of Bridges, highlighting the challenges of implementing novel interventions.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 15
There are two types of participants:
1. All patients with a stroke diagnosis admitted to service for 12 month period following the initial Bridges training workshop
- Received the Bridges approach
- Over the age of 18 years
- Able to provided own consent
2. All staff from the SCDHB acute and community care stroke team will be targeted for Bridges training. This team includes physiotherapists, occupational therapists, social workers, speech language therapists, nurses, senior medical officer, dieticians, and clinical nurse specialists. all staff attending the Bridges training workshop will be eligible for recruitment.
Patients with stroke:
- Not a stroke diagnosis, e.g. a TIA
- Did not receive the Bridges approach
- Under 18 years of age
- Inability to provide informed consent
Staff participants:
- Did not receive the Bridges training
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Qualitative semi-structured indepth one-on-one interviews with consenting staff, patients, and managers: 6-12 months post-intervention qualitative evaluation exploring topics of context specific factors, staffing, facilities, engagement and perceptions. The interviews will be facilitated by members of the research team, audio-recorded and transcribed in full by a commercial transcribing firm (instructed to ensure anonymity of participants and organisations). Interviews will take place at a venue acceptable to the interviewees.[4-6 months post discharge]
- Secondary Outcome Measures
Name Time Method Functional Independence Measure[one year post discharge];duration of hospital stay collected from hospital records[at discharge];discharge destination collected from hospital records[at discharge]