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Table 4 Difference in nurses’ application of 30 quality indicators before and after implementation of the Stroke Nursing Guideline (N = 14)

From: Implementation and feasibility of the stroke nursing guideline in the care of patients with stroke: a mixed methods study

  Pre-test group M (SD) Post-test group M (SD) p-value
Mobility and activities of daily living    
Assess mobility and self-care capabilities on admission to the ward with    
 a) FIM scale 1.818 (0.982) 1.727 (0.273) 0.655
 b) scale in patient electronic health records 2.909 (1.640) 3.091a (1.446) 0.672
 c) both FIM scale and scale in electronic patient health records 1.750 (1.036) 2.000a (1.195) 0.157
Assist patient with getting in and out of the bed on the first shift on the ward 4.077 (0.760) 4.231a (0.726) 0.157
Assist and supervise patient to transfer between bed and chair 4.462 (0.877) 4.615a (0.650) 0.157
Assist and supervise patient with exercises according to physical therapists’ recommendations 3.692 ((1.032) 4.308b (0.947) 0.023 b
Assist patient in ADL and coach transferral of exercises into ADL 4.308 (1.109) 4.385a (0.768) 0.739
Assist patient with hemiplegia to exercise the paralysed arm 3.462 (1.050) 3.615a (1.193) 0.564
Assist patient with hemiplegia to make personal goals in writing if needed 3.846 (1.068) 3.769 (1.166) 0.705
Falls    
Assess risk of falls with MORSE scale 2.846 (1.519) 3.231a (1.092) 0.129
Pain    
Prevent shoulder pain by comforting the paralysed arm 4.846 (0.376) 4.923a (0.277) 0.317
Teach patient how to prevent shoulder pain 4.000 (1.000) 4.308a (1.109) 0.234
Teach family how to prevent shoulder pain 3.417 (0.669) 3.667a (0.888) 0.317
Grade patient’s pain by pain scale 3.692 (1.109) 3.385 (0.961) 0.157
Use non-pharmacological pain interventions 3.250 (1.056) 3.833a (0.835) 0.107
Depression    
Assess symptoms of depression with a depression scale 1.231 (0.599) 1.846b (0.801) 0.033 b
Refer patient to a psychologist due to depression 2.857 (1.351) 3.071b (1.207) 0.438
Refer patient to other HCPs e.g., chaplain or social worker 2.750 (1.139) 2.500 (0.798) 0.180
Provide emotional support e.g., with active listening 4.429 (0.646) 4.214 (0.699) 0.083
Encourage patient to believe in own ability by identifying his/her strength and progress in the rehabilitation 4.643 (0.497) 4.286 (0.611) 0.025* b
Coach patient to relax e.g., by listening to music 3.167 (1.267) 3.500a (1.382) 0.305
Take time to talk with patient 4.143 (0.663) 4.429b (0.514) 0.046 b
Take time to talk with family 4.071 (0.730) 4.357b (0.633) 0.046 b
Patient teaching    
Give patient individualized teaching material upon admission 2.583 (1.240) 2.833a (1.193) 0.048
Secure patient teaching about stroke, its consequences and planned diagnostic tests and treatment 3.071 (1.269) 3.429a (1.089) 0.227
Secure family teaching about stroke, its consequences and planned diagnostic tests and treatment 3.077 (1.188) 3.615a (0.650) 0.052
Teach patient about the importance that the family participates with patient in rehabilitation 3.692 (1.437) 3.846a (1.068) 0.564
Teach family about the importance of their participation with patient in rehabilitation 3.667 (1.371) 3.917* (1.165) 0.257
Discharge planning    
Document discharge planning in patient electronic health records 2.833 (1.267) 3.917b (1.084) 0.012 b
Assess patient’s need for social support after discharge 4.214 (0.893) 4.143 (0.864) 0.739
Assess mobility and self-care capabilities in discharge planning with    
 a) FIM scale 1.727 (1.272) 2.000a (1.095) 0.317
 b) scale in patient electronic health records 2.500 (1.650) 2.700a (1.494) 0.480
 c) both FIM scale and scale in electronic patient health records 2.125 (1.356) 1.750 (1.165) 0.180
Conduct discharge planning interview, provide personalized information 3.000 (1.291) 2.923 (1.256) 0.739
  1. a=differences, b = significant differences