Objective:The objective of this study was to evaluate the feasibility and effectiveness of an innovative school stroke and heart attack educational programme for children.Design:Non-randomised controlled trial with intervention and control group conducted in set time periods. Results were compared among time periods in both groups and also between both groups.Setting:The study included children from 47 schools in Czech Republic. Children from 37 schools in one county ( N = 2,436) participated as the target population. The control group involved 900 pupils from 10 schools in another county.Methods:The 45-minute multimedia Web-based video programme was designed to teach the appropriate response to stroke and heart attack symptoms. The target population received education and testing. The control population received only testing and no education.Results:Baseline knowledge assessment was identical across the target and the control populations. After education, knowledge in the target population had improved significantly. After 3 months, knowledge assessment scored 65% in the target population and 66% in the control population (intergroup difference p = .75).Conclusion:The educational programme increased response to stroke and heart attack symptoms compared to the control group, although in the target group comprehension improved only in short term when compared to the baseline. Knowledge for heart attack was better than for stroke.
Background: Clinical need exists to shorten door-to-needle time (DNT) for intravenous thrombolysis but effective training methods are missing. Simulation training improves teamwork and logistics in numerous fields but it is not clear if simulation improves logistics in stroke. Methodology This is a nation-wide study to evaluate efficacy of simulation training conducted between 2016-2018 and measured by DNT in centers participating in simulation training program as compared to the rest of stroke centers in the Czech Republic. Information about DNT was obtained from prospectively collected data from nationally used Safe Implementation Treatment in Stroke Registry (SITS). Outcome is improvement in DNT in 2018 as compared to 2015 (after and before the simulation training period). Scenarios are based on real clinical cases and are initiated by pre-notification from EMS through indication of thrombolysis and ends by indication for mechanical thrombectomy. Simulation courses were conducted in standardly equipped simulation center (hospital bed, stretcher, simulation monitor, artificial CT scanner, audiovisual equipment etc.). Results: Between 2016 and 2018, 10 courses were conducted for stroke teams from 9 of all 45-stroke centers in the Czech Republic. DNT was available both in 2015 and 2018 in 41 (91%) of 45 stroke centers. Stroke centers that passed simulation training improved their DNT in 2018 as compared to 2015 by 30 minutes (95%CI 25.7-34.7) as compared to 20 minutes (95%CI 15.8-24.3) in stroke centers that did not pass the simulation training (p=0.01). Conclusion: DNT considerably shortened in all stroke centers and simulation training additionally improved door-to-needle time by 10 minutes. Simulation training is useful training method to improve logistics in stroke.
Background: Lack of response to stroke symptoms is one of the most important reasons for patients late arrival to hospital. After we documented that stroke awareness campaign have very little effect on adults, we have developed program aiming to increase response to stroke symptoms in school children. Our study previously showed that, after one 45-minutes lesson, knowledge in stroke and MI in children increases, but does not retain at 3 months. Here we present results after additional lesson at 6 month was introduced. Methodology: Computer based 45 minutes lesson includes a) educational e-learning part and b) video records demonstrating different symptoms of stroke or MI to pretest and posttest the knowledge. Effect of two lessons at baseline and 6 months was tested as % of correct response to 8 questions/simulation video records. Results: Knowledge of 429 participating children increased by 8% (baseline pretest=62%; baseline posttest=70%, p<0.05) after the first lesson. The knowledge decreased after 6 months but increased again by 6% after the repeated lesson at 6 month (from 67% to 73 %, p<0.05). Conclusion: Retention at 6 months was moderate and second lesson at 6 month further but modestly improved children’s knowledge/response to stroke symptoms. One lesson is not enough; two lessons are better but still have moderate cumulative effect.
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