Recommendations for Implementing the INTERACT3 Care Bundle for Intracerebral Hemorrhage in Latin America: Results of a Delphi Method.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY Cerebrovascular Diseases Pub Date : 2024-07-04 DOI:10.1159/000540038

Ma Ignacia Allende, Paula Muñoz-Venturelli, Francisca Gonzalez, Francisca Bascur, Craig S Anderson, Menglu Ouyang, Baltica Cabieses, Alexandra Obach, Vanessa Cano-Nigenda, Antonio Arauz

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Abstract

Introduction: The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT3) showed that the implementation of a care bundle improves outcomes after acute intracerebral hemorrhage (ICH). We aimed to establish consensus-based recommendations for the broader integration of the care bundle across Latin American countries (LAC).

Methods: A 3-phase Delphi study allowed a panel of 32 healthcare workers from 14 LAC to sequentially rank statements relevant to 7 domains (training, resources/infrastructure, patient education, blood pressure, temperature, glycemic control, and anticoagulation reversal). The pre-defined consensus threshold was 75%.

Results: A total of 43 statements reached consensus by the third round, with 12 new statements emerging through rounds. The highest-ranked statements in each domain emphasized critical aspects, but successful implementation requires appropriate resourcing. Key priorities were continuous training of all healthcare workers in ICH management, establishing protocols aligned with available resources, and collaborative interdisciplinary care supported by institutional networks. Statements related to anticoagulation reversal had the highest priority.

Conclusions: Consensus statements are provided to facilitate integration of the INTERACT3 care bundle to reduce disparities in ICH outcomes in LAC.

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在拉丁美洲实施 INTERACT3 脑内出血护理包的建议：德尔菲法的结果。

简介：第三次急性脑出血降压重症监护捆绑试验（INTERACT3）表明，实施护理捆绑可改善急性脑出血（ICH）后的预后。我们旨在建立基于共识的建议，以便在拉丁美洲国家（LAC）更广泛地整合护理包：由来自 14 个拉美国家的 32 名医护人员组成的小组通过三阶段德尔菲研究，对 7 个领域（培训、资源/基础设施、患者教育、血压、体温、血糖控制和抗凝逆转）的相关声明依次进行排序。预先确定的共识阈值为 75%：结果：在第三轮讨论中，共有 43 项声明达成了共识，其中 12 项新声明是在各轮讨论中产生的。每个领域中排名最高的声明都强调了关键方面，但成功实施需要适当的资源。重点是对所有医护人员进行 ICH 管理方面的持续培训、制定与可用资源相匹配的方案以及在机构网络支持下开展跨学科协作护理。与抗凝逆转相关的声明具有最高优先级：本报告提供了共识声明，以促进 INTERACT3 护理包的整合，减少拉丁美洲和加勒比地区 ICH 结果的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.