Oral Presentation Smart Strokes Annual Scientific Meeting 2025

Empowering Voices of Frontline Clinicians to Determine Their Perceptions of Barriers and Strategies for Delivering Stroke Education to Inpatients Through CARES (Consumer-informed Approach to Risk reduction Education for Stroke inpatients) Quality Improvement Project. (127109)

Jodi Rheinberger 1 , Dakota Steris 2 , Emily Sanderson 2 , Olivia Lamaro 2 , Colette Sanctuary 3 , Jaclyn Birnie 4 , Sally Ormond 1 , Di Marsden 1
  1. Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
  2. G2 John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
  3. Belmont Hospital, Hunter New England Local Health District, Belmont, NSW, Australia
  4. Armidale Hospital, Hunter New England Local Health District, Armidale, NSW, Australia

INTRODUCTION: National Stroke Clinical standards(1) recommend patients receive education prior to discharge. We aimed to determine clinician perceptions of barriers to providing education, and clinically-relevant strategies to enhance education.

METHODS: Conducted at two NSW hospitals (metropolitan=1, regional=1) undertaking an inpatient education quality improvement project (CARES) . Clinicians working with stroke inpatients were invited to participate. The 3-minute, web-based survey was informed by the Theoretical Domains Framework and designed by stakeholders. Clinicians could choose up to 5 of 13 barriers and 5 of 11 strategies identified as clinically-relevant by stakeholders. Descriptive statistics are reported.

RESULTS: Responses received from 124 clinicians: female=85%; nurses=46%, allied health=52%; metropolitan=60%, regional=40%; identified as Aboriginal=4%; provided stroke education regularly=27%, sometimes=67%.

Main barriers were time (60%), ability of patient to take on information (44%), confidence (37%), followed by knowledge, resources, and availability of family (all 33%).

Three barriers were identified by more clinicians who provided education “sometimes” compared to “often”. These were confidence (sometimes=45%, often=21%), remembering to do (sometimes=24%, often=6%), and not knowing enough about the patient’s stroke type/management (sometimes=41%, often=15%).

The highest-rated strategy to enhance inpatient stroke education was the availability of paper resources eg My Stroke Journey, fact sheets (65%). Followed by inservices to clinicians about stroke types/management (54%), and in equal third, group education to stroke patients/ family by stroke clinicians, stroke patients managed on stroke ward, and hospital-specific video accessed by QR code/ link (52%).  

CONCLUSION: We identified key barriers perceived by frontline clinicians in delivering stroke education to inpatients; and their most highly-rated, clinically relevant strategies for delivering education. This study will inform solutions to enhance inpatient and carer education through CARES.

RELEVANCE: Through strong collaboration and active listening, we empowered the voices of metropolitan and regional frontline clinicians in study design, and identification of perceived barriers and strategies for inpatient stroke education.

  1. Australian Commission on Safety and Quality in Health Care. Acute Stroke Clinical Care Standard. Sydney; ACSQHC, 2019.