Effectiveness of Best Care Practices in Acute Stroke in Conventional Hospitalization (BEST CARE ICTUS_HC)

Summary

The goal of this clinical trial is to evaluate whether a multicomponent nurse-led intervention (BEST CARE ICTUS\_HC) can reduce stroke-related complications and improve recovery in adults (18 years and older) hospitalized with an acute ischemic or hemorrhagic stroke in hospitals without specialized Stroke Units. The main questions it aims to answer are:

1. Does the implementation of the program increase the early and correct detection of swallowing difficulties (dysphagia) to prevent pneumonia?
2. Does the program reduce the severity of attention problems (hemineglect) and improve the patients' quality of life up to 6 months after discharge?

Researchers will compare patients receiving the BEST CARE ICTUS\_HC program to patients receiving usual hospital care to see if this new approach improves patient safety and long-term functional recovery.

Participants will:

* Receive either the usual hospital care for stroke or the BEST CARE ICTUS\_HC nursing program, depending on the study phase of the hospital.
* Be screened for swallowing problems using a standardized test before receiving any food or drink.
* Be cared for in an adapted environment (FLECHA Project) that uses visual signs and room organization to help with orientation and safety.
* Have their temperature, blood sugar, and blood pressure monitored under a strict specialized protocol.
* Be contacted by phone 30 days and 6 months after leaving the hospital to answer questions about their health and quality of life.

Conditions

• Stroke
• Acute Stroke
• Ischemic Stroke
• Hemorrhagic Stroke
• Cerebrovascular Disorders
• Deglutition Disorders
• Perceptual Disorders
• Unilateral Neglect
• Pneumonia, Aspiration

Interventions

OTHER

BEST CARE ICTUS_HC BUNDLE

Multicomponent nursing intervention including: 1) Specialized staff training on acute stroke care. 2) Systematic dysphagia screening using the Modified Swallowing Assessment (MSA). 3) Implementation of the "FLECHA Project", a compensatory care model that harmonizes all care delivery based on stroke laterality aimed at developing early functional rehabilitation for unilateral neglect, hemiplegia, hemiparesis, and anosognosia (strategies include use of bedside pictograms, spatial reorganization, and QR-guided specific care plans). 4) Protocols for physiological stability monitoring and early device removal.

Sponsors & Collaborators

• Instituto de Salud Carlos III

  collaborator OTHER_GOV

• Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud

  collaborator OTHER

• Andalusian Health Service

  collaborator OTHER_GOV

• University of Malaga

  lead OTHER

Principal Investigators

• JOSE MIGUEL MORALES-ASENCIO, PhD · Universidad de Málaga

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-05-12

Primary Completion

2028-12-31

Completion

2028-12-31

Countries

• Spain

Study Locations