London, United Kingdom 2013 Poster Session Nurses/AHP’s Cerebrovasc Dis 2013; 35 (suppl 3)1-854 197 2002 Acute stroke: clinical patterns and practise including nursing Standardized nutritional assessment and the risk of death after stroke. Results from a na-tion- wide Danish quality-control registry of 81 007 patients with acute stroke. M. Lehmkuhl1, G. Walløe2, C. Dehlendorff3, T.S. Olsen4 The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK1, The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DJIBOUTI2, Danish Cancer Society Re-search Center, Copenhagen, DENMARK3, The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK4 Background: Nutrition is a core service in stroke care. Standardized nutrional assessment within the first 2 days of admission has been considered a quality-of-care criterion in stroke care in Denmark and fulfilment of this goal has been registered nation-wide since 2003. We studied if fulfilment of this quality-of-care criterion had an influence on stroke survival. Methods: The Danish Stroke Registry of all hospitalized stroke patients in Denmark established 2003 includes 81 007 acute stroke patients in whom nutritional assessment was considered clinically relevant. The registry contains data on age, sex, civil status, residence, stroke severity (Scandinavian Stroke Scale (SSS) 0-58), computed tomography, and cardiovascular risk factors. Information on death within 1 week and 1 month were obtained through the Danish Death Registry. Logistic regres-sion modeling was used to study the independent association between timely performance of a nutri-tional assessment within 2 days and death within 1 week and 1 month post stroke. Results: Mean age 72.0 years, 48% women, mean SSS 41.5. Nutritional assessment was performed within 2 days of admission in 65 618 patients (81%) while not in 15 389 patients (19%). In the mul-tiple logistic regression analysis adjusting for age, sex, civil status, residence, stroke severity (SSS), computed tomography, and cardiovascular risk factors mortality was significantly reduced in pa-tients having had nutritional assessment within 2 days of admission: 1-week mortality OR 0.61, CI 0.52-0.71; 1-month mortality OR 0.64, CI 0.57-0.71. Conclusion: The lower mortality registered in patients having had timely nutritional assessment could reflect the impact of higher nursing standards. However, it cannot be excluded that the lower mortality is a result of selection, not least because the lower mortality were recorded also within the first week after the stroke where nursing care consequences of the assessment can hardly be fully implemented. 2003 Acute stroke: clinical patterns and practise including nursing Specialist Stroke Pharmacists: a vital role on London’s Hyper Acute Stroke Units R. Tolhurst1, C. Goldsmith2, I. Rowlands3, P. Parmar4, M. Williams5 King’s College Hospital NHS Foundation Trust, London, UNITED KINGDOM1, St George’s Healthcare NHS Trust, London, UNITED KINGDOM2, Imperial College Healthcare NHS Trust, London, UNITED KINGDOM3, The North West London Hospitals NHS Trust, London, UNITED KINGDOM4, South London Healthcare NHS Trust, London, UNITED KINGDOM5, South London Healthcare NHS Trust, London, UNITED KINGDOM6 Background: The role of a clinical pharmacist in an Acute NHS Trust in the UK is generally well recognised and well recorded. Less is known about the relatively new role of a Specialist Pharmacist on a Hyper Acute Stroke Unit (HASU). The aim of this study was to attempt to provide quantita-tive and qualitative data to demonstrate the value of contributions pharmacists make on HASUs in London. Methods: Pharmacists from five of the eight HASUs in London collected both intervention and clinical metrics (operational) data for a period of five days. A generic data collection tool was used for both data sets collected. Interventions were catagorised by type, drug group involved and acceptance. Clinical metrics data included tasks commonly carried out on the ward such as number of Medicines Reconciliation activities completed, number of medication discrepancies that required resolving, clinical screening of drug charts, and discharges facilitated. All data was self-collected. Results: In total 577 interventions were made, representing a rate of 3.2 interventions per HASU patient. 214 Medicines Reconciliation activities were completed, giving an average of 8.5 reconcili-ations per HASU per day. The primary reason for the majority of the interventions made (56%) was safety, either to prevent or in response to an adverse drug reaction or side effect. 25% of interven-tions made were for efficacy, to ensure optimal treatment for HASU patients. 13% of interventions were to reduce the patients’ length of stay and expedite discharge. Conclusion: The type and quanti-ty of interventions recorded demonstrate that Specialist Stroke Pharmacists play a vital role in a pa-tients journey through London’s HASUs, contributing to the safe and effective use of medicines in this setting whilst smoothing admissions and speeding up discharges.
Karger_ESC London_2013
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