22. European Stroke Conference 2004 Acute stroke: clinical patterns and practise including nursing Reducing door-to-consent time: neuroradiographers as key witnesses J.C. Semple1, M. Jones2, M. Sheehan3, G.W.J. Harston4, J. Kennedy5 AVIC, Oxford University, Oxford, UNITED KINGDOM1, AVIC, Oxford University, Oxford, UNITED KINGDOM2, Oxford University, Oxford, UNITED KINGDOM3, AVIC, Oxford Universi-ty, Oxford, UNITED KINGDOM4, AVIC, Oxford University, Oxford, UNITED KINGDOM5 Background Expecting stroke patients to comprehend the extensive documentation required to gain informed consent into acute MRI research studies presents several difficulties: it can add to delays in enrol-ment; it does not easily accommodate capacity issues; it fails to address the concurrent need for MR safety screening; and it can potentially lead to biased study populations. An independently witnessed verbal enrolment process conforms to the UK legal requirements of gaining informed consent and may reduce door-to-enrolment time. We report the experience of using neuroradiographers to fulfil this role of independent witness and its impact on research enrolment. Methods Patients with acute ischaemic stroke are screened in the Emergency Department by the research team. Consent is gained through a verbal process facilitated by visual aids. If capacity is uncertain verbal advice is sought from a personal consultee (PC). A neuroradiographer independent to the re-search study witnesses and documents this process, simultaneously assessing MRI safety. Written consent is gained in the subsequent 24hrs. Quantitative and qualitative feedback is collected. Results 15 patients have been recruited and undergone serial research MRI. Median onset-to-MRI time is 3hr20min, which compares favourably to the MR RESCUE study (5hr30min). Median NIHSS is 6 (range 0-27). tPA was administered to 4 patients. 5 lacked capacity to consent and advice was sought from a PC. Feedback has been uniformly positive. Several felt that the verbal process was more informative than the documentation recommended by current guidance. None has refused consent during the written process having given initial verbal consent. Conclusion Neuroradiographers acting as independent witnesses enable consent while screening for MRI safety. Feedback from study participants is uniformly positive and such an approach may reduce door-to-enrolment times in acute stroke research. 198 © 2013 S. Karger AG, Basel 7. Nurses & AHP‘s Meeting 2005 Acute stroke: clinical patterns and practise including nursing Clinical Guideline Adherence by Physiotherapists working in Acute Stroke Care in Ireland A. Donohue1, F. Horgan2 St. Vincent’s University Hospital, Dublin, IRELAND1, Royal College of Surgeons in Ireland, Dublin, IRELAND2 BACKGROUND The publication of the Irish Heart Foundation National Clinical Guidelines and Recommendations for the Care of People with Stroke in 2009 provided healthcare professionals with an essential tool for improving stroke services in Ireland. There is negligible information available regarding guide-line adherence by Irish physiotherapists in acute stroke care. The aim of this study was to identify the degree to which Senior Physiotherapists in acute stroke care adhered to the Irish Clinical Guide-lines for Stroke. METHODS In this observational, cross-sectional study a postal or online survey was distributed to the Senior Physiotherapist responsible for acute stroke care in 31 acute hospitals in the Republic of Ireland, achieving a 74% response rate. RESULTS There was excellent compliance with guidelines for the completion and documentation of full as-sessment within 5 working days of admission (82.6%), early mobilisation (95.7%), the use of stan-dardised assessment tools (82.6%), regular patient communication (100%) and the involvement of the patient in goal setting (82.6%). Poor compliance was reported in relation to guidelines for the provision of early assessment within 24 to 48 hours of admission (43.5%) and adequate rehabilitation intensity of a minimum of 45 min-utes per day (39%) with respondents reporting that the main barriers to compliance in these areas were organisational in nature. Conclusion Although excellent compliance was demonstrated in most areas, poor compliance levels reported may be related in part to poorly organised stroke services in Ireland which have been previously de-scribed in the literature. These findings benchmark Irish acute stroke physiotherapy services against best practice and provide information which may be used to design effective strategies to promote guideline adherence thereby improving patient care in the future.
Karger_ESC London_2013
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