BACKGROUND The Thrombolysis ImPlementation in Stroke (TIPS) trial tested the effect of a multicomponent, multidisciplinary, collaborative intervention designed to increase the rates of intravenous thrombolysis via a cluster randomized controlled trial at 20 Australian hospitals (ten intervention, ten control). This sub-study investigated changes in self-reported perceptions and practices of physicians and nurses working in acute stroke care at the participating hospitals. METHODS A survey with 74 statements was administered during the pre- and post-intervention periods to staff at 19 of the 20 hospitals. An exploratory factor analysis identified the structure of the survey items and linear mixed modeling was applied to the final survey domain scores to explore the differences between groups over time. RESULT The response rate was 45% for both the pre- (503 out of 1127 eligible staff from 19 hospitals) and post-intervention (414 out of 919 eligible staff from 18 hospitals) period. Four survey domains were identified: (1) hospital performance indicators, feedback, and training; (2) personal perceptions about thrombolysis evidence and implementation; (3) personal stroke skills and hospital stroke care policies; and (4) emergency and ambulance procedures. There was a significant pre- to post-intervention mean increase (0.21 95% CI 0.09; 0.34; p < 0.01) in scores relating to hospital performance indicators, feedback, and training; for the intervention hospitals compared to control hospitals. There was a corresponding increase in mean scores regarding perceptions about the thrombolysis evidence and implementation (0.21, 95% CI 0.06; 0.36; p < 0.05). Sub-group analysis indicated that the improvements were restricted to nurses' responses. CONCLUSION TIPS resulted in changes in some aspects of nurses' perceptions relating to the evidence for intravenous thrombolysis and its implementation and hospital performance indicators, feedback, and training. However, there is a need to explore further strategies for influencing the views of physicians given limited statistical power in the physician sample. TRIAL REGISTRATION ACTRN12613000939796, UTN: U1111-1145-6762.

中文翻译：

---

多成分，多学科的实施方案能否改变医生和护士对急性缺血性卒中溶栓治疗的看法和做法？一项集群随机试验的探索性分析。

背景技术中风溶栓治疗（TIPS）试验通过澳大利亚20所医院的整群随机对照试验（旨在研究10种干预措施，10种对照），对多组分，多学科，协作干预措施的效果进行了测试，旨在提高静脉溶栓的发生率。本子研究调查了参与医院中急性卒中护理工作的医生和护士自我报告的观念和实践的变化。方法在干预前后，对20所医院中19所医院的工作人员进行了74项陈述的调查。探索性因素分析确定了调查项目的结构，并将线性混合模型应用于最终调查域得分，以探索不同组之间随时间的差异。结果干预前（来自19家医院的1127名合格员工中的503名）和干预后（来自18家医院的919名合格员工中的414名）的响应率为45％。确定了四个调查领域：（1）医院绩效指标，反馈和培训；（2）对溶栓证据和实施的个人看法；（三）个人中风技能和医院中风护理政策；（4）紧急和救护程序。与医院绩效指标，反馈和培训相关的评分中，干预前至干预后的均值显着增加（0.21 95％CI 0.09； 0.34； p <0.01）。干预医院与对照医院相比。关于溶栓证据和实施的看法，平均得分相应增加（0.21，95％CI 0.06； 0.36； p < 0.05）。分组分析表明，改善仅限于护士的反应。结论提示导致护士对静脉溶栓的证据及其实施，医院绩效指标，反馈和培训的看法在某些方面发生了变化。但是，在医师样本中的统计能力有限的情况下，有必要探索进一步的策略来影响医师的观点。试用注册号ACTRN12613000939796，UTN：U1111-1145-6762。考虑到有限的医生样本统计能力，有必要探索进一步的策略来影响医生的观点。试用注册号ACTRN12613000939796，UTN：U1111-1145-6762。考虑到有限的医生样本统计能力，有必要探索进一步的策略来影响医生的观点。试用注册号ACTRN12613000939796，UTN：U1111-1145-6762。