Removing barriers to evidence translation: Facilitating clinician and patient uptake of evidence-based stroke rehabilitation

Dr Leah Wiseman1

1Albury Wodonga Health, Albury, Australia, 2Charles Sturt University , Albury, Australia

Aim: The project will develop and trial an online resource that addresses clinician cited barriers to implementing the National Stroke Clinical Guidelines and works more collaboratively with patients and their caregivers enabling a long-term, self management approach to rehabilitation after stroke.  This project has focused specifically on cognitive and upper limb interventions as recommended by the National Stroke Clinical Guidelines.

Method: Data collection methods included a series of focus groups involving patients, caregivers and clinicians, eliciting responses regarding barriers and enablers to implementing a self management approach and understanding of cognitive and upper limb interventions within the National Stroke Guidelines. The online resource will be a combination of written information, links with existing on-line resources and instructional videos and will be trialled with over 200 patients who have had a stroke, recruited from two regional health services. Outcome measures include goal achievement, self-reported performance and satisfaction, the Stroke Self-efficacy Questionnaire and the Stroke Impact Scale. Secondary outcome measures will evaluate upper-limb and/or cognitive changes following the program. The extent to which clinician cited barriers have been addressed by this resource will be measured via a staff audit.

Results: At the time of presentation, the study will be in the initial stages. Findings from the focus groups and the preliminary evaluation of the resource trial will be presented.

Significance of the findings to allied health: Overall the uptake and application of the National Stroke Foundation’s Clinical Guidelines is a critical success factor in improving the health outcomes of stroke patients. The resource developed aims to overcome many clinician cited barriers and support staff in implementing evidence based practice. The resource adopts a self-management approach which aims to enable patients and caregivers to implement an effective upper limb or cognitive rehabilitation program at home.