Simeon Dale | Australian Catholic University (original) (raw)

Papers by Simeon Dale

BMC health services research, Jan 29, 2024

BMC Nursing

Background Dehydration and malnutrition are common in hospitalised patients following stroke lead... more Background Dehydration and malnutrition are common in hospitalised patients following stroke leading to poor outcomes including increased mortality. Little is known about hydration and nutrition care practices in hospital to avoid dehydration or malnutrition, and how these practices vary in different countries. This study sought to capture how the hydration and nutrition needs of patients’ post-stroke are assessed and managed in the United Kingdom (UK) and Australia (AUS). Aim To examine and compare current in-hospital hydration and nutrition care practice for patients with stroke in the UK and Australia. Methods A cross-sectional survey was conducted between April and November 2019. Questionnaires were mailed to stroke specialist nurses in UK and Australian hospitals providing post-stroke inpatient acute care or rehabilitation. Non-respondents were contacted up to five times. Results We received 150/174 (86%) completed surveys from hospitals in the UK, and 120/162 (74%) in Australi...

Research Square (Research Square), Mar 30, 2023

Implementation Science, Jan 26, 2023

Journal of Stroke and Cerebrovascular Diseases

Stroke, 2015

Background: The Quality in Acute Stroke Care (QASC) Trial 1 determined that a multidisciplinary s... more Background: The Quality in Acute Stroke Care (QASC) Trial 1 determined that a multidisciplinary supported, nurse-initiated, evidence-based intervention involving supported implementation of clinical protocols to manage fever, hyperglycaemia and swallowing (FeSS protocols) following stroke decreased death and dependency by 16% (p=0.002); reduced temperatures (p=0.001) and glucose levels (p=0.02); and improved swallowing management (p=<0.001). Yet, upscale and spread of even proven interventions on a state-wide level is challenging. Aim: To implement the FeSS protocols from the QASC Trial in all 36 stroke services in NSW, Australia. Method: Our 14 month translational project replicated the intervention from the original QASC Trial. We conducted barrier and enabler assessments and an educational workshop, engaged local opinion leaders, used reminders, and provided ongoing site champion support. Participating sites audited 40 pre-, and 40 post- implementation medical records using th...

Cerebrovascular Diseases, 2016

Additional file 2: Table S1. Likelihood of undertaking oral care assessments in the UK and in Aus... more Additional file 2: Table S1. Likelihood of undertaking oral care assessments in the UK and in Australia. Categories unsure, not applicable and no response have been omitted. Table S2. Patient factors reported to influence whether an oral care assessment was undertaken for the UK and Australia. Categories unsure and no response have been omitted. Table S3. Staff factors, organisational factors and patient factors reported to influence oral care provision in the UK and Australia. Categories unsure and no response have been omitted. Figure S1. Oral care products available in UK (left) and Australian (right) hospitals.

Stroke, 2020

Introduction: Fever, Sugar and Swallow (FeSS) protocols following stroke reduce death and depende... more Introduction: Fever, Sugar and Swallow (FeSS) protocols following stroke reduce death and dependency. Introduction of the protocols in the T 3 Trial did not improve Emergency Department (ED) stroke care processes. The CodeStroke2.0 study involved expansion of the acute stroke nurse role to include FeSS implementation but not all post-intervention cohort patients received a CodeStroke2.0 activation. Our secondary analysis determined how effective the intervention was compared to patients who did not receive a CodeStroke2.0 activation. Methods: This single-centre, pre-test/post-test feasibility study compared patients who received the CodeStoke2.0 activation with those who did not as measured by: ED length of stay, uptake of FeSS processes of care, and thrombolysis metrics. Differences between groups were examined using logistic regression, adjusting for age, sex and stroke severity. Results: Of the 117 patients recruited to the post-intervention cohort, 72 (61.5%) received a CodeStro...

Paper version of online questionnaire. Copy of paper based study questionnaire used for online su... more Paper version of online questionnaire. Copy of paper based study questionnaire used for online survey. (PDF 595Â kb)

Background: Clinicians’ compliance with hospital protocols inclusion and exclusion criteria for t... more Background: Clinicians’ compliance with hospital protocols inclusion and exclusion criteria for the administration of Recombinant Tissue Plasminogen Activator (rt-PA) for ischaemic stroke is unknown. We compared hospital protocol rt-PA selection criteria with criteria reported to be used in practice. Methods: Stroke Unit Co-ordinators of all Australian hospitals known to provide rt-PA were mailed a survey. Respondents were asked to report on the inclusion/exclusion criteria used in practice when considering rt-PA administration and to provide their hospital rt-PA protocol. Chi-square tests were used to determine differences between individual hospital protocols and respondent’s self-reported selection criteria. Results: Protocols and completed surveys were received from 55 of the 87 hospitals (63%) containing 9 inclusion and 92 exclusion criteria. There were significant differences between two inclusion criteria: ‘clinical diagnosis of acute ischaemic stroke’ (Practice: 92.1% vs Pro...

Journal of Clinical Nursing, 2021

Implementation Science, 2020

Background The implementation of evidence-based protocols for stroke management in the emergency ... more Background The implementation of evidence-based protocols for stroke management in the emergency department (ED) for the appropriate triage, administration of tissue plasminogen activator to eligible patients, management of fever, hyperglycaemia and swallowing, and prompt transfer to a stroke unit were evaluated in an Australian cluster-randomised trial (T3 trial) conducted at 26 emergency departments. There was no reduction in 90-day death or dependency nor improved processes of ED care. We conducted an a priori planned process influential factors that impacted upon protocol uptake. Methods Qualitative face-to-face interviews were conducted with purposively selected ED and stroke clinicians from two high- and two low-performing intervention sites about their views on factors that influenced protocol uptake. All Trial State Co-ordinators (n = 3) who supported the implementation at the 13 intervention sites were also interviewed. Data were analysed thematically using normalisation pr...

BMC Nursing, 2021

Aims To examine current practice, perceptions of healthcare professionals and factors affecting p... more Aims To examine current practice, perceptions of healthcare professionals and factors affecting provision for oral care post-stroke in the UK and Australia. Background Poor oral care has negative health consequences for people post-stroke. Little is known about oral care practice in hospital for people post-stroke and factors affecting provision in different countries. Design A cross-sectional survey. Methods Questionnaires were mailed to stroke specialist nurses in UK and Australian hospitals providing inpatient acute or rehabilitation care post-stroke. The survey was conducted between April and November 2019. Non-respondents were contacted up to five times. Results Completed questionnaires were received from 150/174 (86%) hospitals in the UK, and 120/162 (74%) in Australia. A total of 52% of UK hospitals and 30% of Australian hospitals reported having a general oral care protocol, with 53% of UK and only 13% of Australian hospitals reporting using oral care assessment tools. Of th...

Nursing Outlook, 2021

BACKGROUND Emergency departments (ED) are challenging environments but critical for early managem... more BACKGROUND Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. PURPOSE To identify how context affects the provision of stroke care in 26 Australian EDs. METHOD Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. FINDINGS Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. DISCUSSION Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.

Stroke, 2018

Background: Socio-economic factors (SES) are associated with mortality, morbidity and access to h... more Background: Socio-economic factors (SES) are associated with mortality, morbidity and access to health services. For optimal outcomes following stroke, it is critical that patients present to Emergency Departments (ED) with minimal delay after the onset of stroke symptoms. Purpose: To identify the relationship between residential postcode-based Socio-Economic Indexes For Areas (SEIFA), which ranks geographical areas in terms of relative socioeconomic advantage and disadvantage, and time to ED presentation after the onset of stroke symptoms. Methods: We used data from the pre-implementation cohort of the Triage, Treatment and Transfer of patients with stroke in ED’s (T 3 trial) - a cluster randomized controlled trial conducted in 26 Hospitals in three states and one territory in Australia. SEIFA index scores were categorised into tertiles. A multivariable Cox regression modeled the relationship between SEIFA groups and time to ED presentation from symptom onset, adjusting for highest...

International Journal of Stroke, 2018

Interventional Neurology, 2018

Background: Strict criteria for recombinant tissue plasminogen activator (rtPA) eligibility are s... more Background: Strict criteria for recombinant tissue plasminogen activator (rtPA) eligibility are stipulated on licences for use in ischaemic stroke; however, practitioners may also add non-standard rtPA criteria. We examined eligibility criteria variation in 3 English-speaking countries including use of non-standard criteria, in relation to rtPA treatment rates. Methods: Surveys were mailed to 566 eligible hospitals in Australia (AUS), the UK, and the USA. Criteria were pre-classified as standard (approved indication and contraindications) or non-standard (approved warning or researcher “decoy”). Percentage for criterion selection was calculated/compared; linear regression was used to assess the association between use of non-standard criteria and rtPA treatment rates, and to identify factors associated with addition of non-standard criteria. Results: Response rates were 74% AUS, 65% UK, and 68% USA; mean rtPA treatment rates were 8.7% AUS, 12.7% UK, and 8.7% USA. Median percentage o...