AUTHOR=Zheng Dongxiang , Li Shengjuan , Ding Yan , Chen Huaihua , Wang Dong , Wang Huan , Xie Yuyao , Li Chen , Luo Jinglan 

TITLE=Effects of nurse-led hierarchical management care on acute stroke patients: A pilot study to promote stroke-associated pneumonia management

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1121836

DOI=10.3389/fneur.2023.1121836

ISSN=1664-2295

ABSTRACT=Background: Stroke-related pneumonia (SAP) is a common complication in acute ischemic stroke (AIS) patients, and it has adverse effects on clinical outcomes and increases the burden on families and society. Early identification and individualized care are necessary to reduce the incidence of SAP.
Objective: To explore the effect of nurse-led hierarchical management care based on the acute ischemic stroke-associated pneumonia score (AIS-APS) scale in AIS patients.
Methods: A quasi-intervention pilot study design was adopted for the present study.
AIS patients were enrolled and assigned to the intervention group or control group (n=60 per group) in one tertiary hospital in Guangzhou, China. The control group received routine care, whereas the intervention group was given nurse-led hierarchical management care based on the AIS-APS scale. The intervention duration was more than seven days, and the incidence of SAP, neurological function, swallowing function, and activities of daily living (ADL) at discharge were observed. Outcomes were assessed at baseline and at outpatient time.
Results: A total of 120 participants were enrolled in our study. A significant decrease was found in the incidence of SAP in the intervention group (18.3%) compared with
the control group (41.7%). Positive outcomes were shown in neurology function, swallowing function and ADL in the intervention group.
Conclusion: Nurse-led hierarchical management care based on AIS-APS can reduce the incidence of SAP, promote AIS patients’ neurological function, and maintain patients’ ADL. The results of our study indicated that nurse-led hierarchical management care is feasible for AIS patients and provides individualized interventions for patients with different levels of SAP risk. Nurse-led hierarchical management care could be incorporated into routine nursing practice.
Further study is needed and expected to solve more clinical problems.