The NICS care bundle: aiming to improve the initial care of patients with stroke and transient ischaemic attack

Jayantha I Weeraratne, Annette J Lenstra, Andrew W Lee, Kelvin M Hill, Susan D Huckson and Jodie L Clydesdale
Med J Aust 2010; 193 (7): . || doi: 10.5694/j.1326-5377.2010.tb03962.x
Published online: 4 October 2010

Introducing an innovative, evidence-based resource for use in the emergency department

In early 2008, the National Institute of Clinical Studies (NICS) Stroke Clinical Reference Group was formed to develop an acute stroke care resource for use in emergency departments (EDs) in Australian hospitals. The NICS reference group used a care bundle approach to develop a guideline implementation tool based on specific recommendations from the 2007 National Stroke Foundation (NSF) Clinical guidelines for acute stroke management relevant for ED care.1 Although these guidelines were already available, there are well known barriers to guideline implementation in the ED. These include increasing demand and acuity, and the broad diversity of clinical presentations. Clinical information provided for ED clinicians needs to be concise and relevant to the emergency care context. The nine-member NICS reference group represented a collaboration between stroke and ED specialists, prehospital providers and managers of state-based stroke networks, with additional guidance from the NSF.

  • Jayantha I Weeraratne1,2
  • Annette J Lenstra3
  • Andrew W Lee4,3
  • Kelvin M Hill5
  • Susan D Huckson3
  • Jodie L Clydesdale3

  • 1 Emergency Department, Angliss Hospital, Melbourne, VIC.
  • 2 Emergency Department, Knox Private Hospital, Melbourne, VIC.
  • 3 National Institute of Clinical Studies, National Health and Medical Research Council, Melbourne, VIC.
  • 4 Flinders Comprehensive Stroke Centre, Flinders Medical Centre, Adelaide, SA.
  • 5 National Stroke Foundation, Melbourne, VIC.



We would like to acknowledge the contribution of the NICS Stroke Clinical Reference Group in the development of the care bundle. The NICS care bundle was reviewed by national and international experts in both clinical care and bundle methodology; endorsed by the NSF, the Australasian College for Emergency Medicine, the Australian College of Emergency Nursing and the College of Emergency Nursing Australasia; and approved by the NHMRC.


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