{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:02:09Z","timestamp":1785495729999,"version":"3.56.0"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":211,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Stroke Research and Treatment"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stroke is increasing in low\u2010 and middle\u2010income countries. Stroke unit care, including evidence\u2010based practice such as swallowing and hydration protocols, is associated with reduced disability and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study is to codesign a swallowing and hydration care bundle for nurses to use with acute stroke patients, and to implement and evaluate the bundle on three acute stroke units across India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicentre, preimplementation and postimplementation feasibility study was conducted. We codesigned a care bundle (with stakeholders) which included the Global Evaluation of Swallowing and hydration screening and related actions\/management. Implementation used clinical champions, education and training, barrier and enabler identification and site support. Participants included consecutively admitted patients, aged \u2265\u200918 years, with a clinical diagnosis of acute stroke and a persistent neurological deficit on presentation, who were admitted to a study site within 2 weeks of stroke onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010three healthcare staff completed the care bundle training. We recruited 183 participants, preimplementation group (\n                      <jats:italic>n<\/jats:italic>\n                      = 92). Swallowing evaluations using different consistencies increased from 22 (23.9%) to 51 (56%). Calculated osmolarity (cOsm) increased from 0 to 66 (73%) participants. Median cOsm was 288\u2009mmol\/L (IQR: 280\u2013295\u2009mmol\/L); 15 (23%) participants were dehydrated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Care bundle implementation was feasible and improved swallowing and hydration management in three sites in India.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/srat\/9745360","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T10:51:08Z","timestamp":1785495068000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Codesign, Development and Implementation of an Indian Poststroke Swallow and Hydration Care Bundle: A Feasibility Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4647-6392","authenticated-orcid":false,"given":"Elizabeth","family":"Boaden","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5016-3471","authenticated-orcid":false,"given":"C. 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