Impact of order sets on outcome of acute ischemic stroke
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 600
- Locations
- 1
- Primary Endpoint
- To assess the effect of standardized order sets on the functional outcomes of patients with acute ischemic stroke, measured by the modified Rankin Scale (mRS) at discharge.
Study Overview
Brief Summary
Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality globally, accounting for a significant portion of the overall stroke burden. In India, stroke incidence is increasing, with a substantial impact on the rural population due to limited access to specialized stroke care facilities. Timely and effective management of acute ischemic stroke is crucial in reducing the associated disability and death rates.
Standardized order sets, which are pre-defined templates that guide clinical decision-making and treatment protocols, have been shown to improve the quality of care in various medical conditions, including stroke. These order sets can streamline the management process, ensuring that critical interventions such as thrombolysis are administered promptly and that care adheres to evidence-based guidelines.
The implementation of order sets for stroke management has demonstrated positive outcomes in several studies conducted in high-resource settings. The American Stroke Association recommends the use of standardized order sets to enhance the efficiency and effectiveness of acute stroke treatment. However, there is a paucity of data on the impact of such interventions in resource-limited settings, particularly in rural India.
In rural tertiary care hospitals in India, the challenge is compounded by factors such as delayed patient presentation, inadequate infrastructure, and lack of trained personnel. These challenges often result in sub-optimal stroke care and poorer outcomes. Therefore, introducing standardized order sets in such settings could potentially bridge the gap in stroke management quality and improve patient outcomes.
This study aims to evaluate the impact of implementing standardized order sets on the outcomes of patients with acute ischemic stroke in a tertiary care rural hospital in India. By examining key metrics such as functional outcomes, time to critical interventions, length of hospital stays, and in-hospital mortality, this research seeks to provide evidence for the effectiveness of order sets in improving stroke care in a resource-limited environment.
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Study Design
- Study Type
- Observational
Eligibility Criteria
- Ages
- 18.00 Year(s) to 99.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •Patients aged 18 years and above.
- •Diagnosed with acute ischemic stroke confirmed by Neuro-imaging (CT or MRI).
- •Patients admitted under Neurology department of the hospital.
Exclusion Criteria
- •Patients with hemorrhagic stroke.
- •Patients with transient ischemic attack (TIA).
- •Patients or families who decline participation in the study.
Outcomes
Primary Outcomes
To assess the effect of standardized order sets on the functional outcomes of patients with acute ischemic stroke, measured by the modified Rankin Scale (mRS) at discharge.
Time Frame: Measured by the modified Rankin Scale(mRS)scores at discharge.
Secondary Outcomes
- Impact on outcome of thrombolysis(Time from patient arrival at the emergency department to the administration of thrombolytic therapy)
- The length of hospital stay for patients with acute ischemic stroke.(Total days of hospital stay)
- In-hospital mortality rates among patients with acute ischemic stroke.(Total days of hospital stay.)
- Overall adherence to stroke management guidelines before & after the implementation of standardized order sets.(Total days of hospital stay)
Investigators
Dr Sarang Dilip Videkar
Jawaharlal Nehru medical college,Wardha,Maharashtra,Pincode 442107