Background: Hospital-acquired complications including falls, infections, delirium, shoulder-injuries, pressure-injuries, and malnutrition are common in hospitalised acute stroke patients. Implementation of prevention strategies are integral for patient safety and avoiding catastrophic outcomes, warranting their inclusion in Australia’s national stroke clinical care recommendations. Patient safety huddles have been identified as effective intervention in other settings. However, nurse-led multidisciplinary patient safety huddles addressing aggregated patient risk have not been trialled on acute stroke units. Assessing staff perceptions of implementing a patient safety huddle intervention are important as these form a strong predictor of staff engagement and longevity of successful implementation.
Aims: To evaluate staff perceptions of a nurse-led acute stroke unit multidisciplinary patient safety huddle ‘Risk Assessment and Management Plan’ (RAMP) implementation.
Methods: A pre-and post-trial evaluation questionnaire involving staff demographics, the modified Hospital Survey on Patient Safety Culture(mHSOPS) Likert questionnaire and open-ended questions. The multidisciplinary stroke team consisted of nursing, dietitian, occupational therapy, physiotherapy, speech pathology, allied health assistants, and medical staff.
Results: From 82-questionnaire responses (pre-trial n=32, post-trial n=50), nursing was the largest professional group 67% (n=55), undergraduate degree was the highest level of education for 90% (n=74), and clinical-experience ranged from 2-months to 25-years (median3.5-years). The mHSOPS evaluated staff perception /25 in each domain pre-and post-trial; (i)implementing patient safety strategies (IPSS) (pre-14, post-19 p=<0.0001), (ii)consistent approach to assessing for IPSS (pre-14, post-19 p=<0.0001), (iii)culture of IPSS (pre-13, post-19 p=<0.0001), (iv)standardised documenting of IPSS (pre-12, post-19 p=<0.0001), (v)positive communication of IPSS (pre-12, post-19 p=<0.0001), and (vi)team work opportunity to evaluate performance (pre-12, post-19 p=<0.0001).
Conclusion: The results of this real-world nurse-led multidisciplinary patient safety quality improvement trial are highly encouraging. Demonstrating a significant improved patient safety culture through building capacity of multidisciplinary teamwork and IPSS completion. Further evaluation of the patient impact of RAMP on acute stroke units is now warranted.