Knowledge Translation in Right Brain Rehabilitation: A Feasibility Study of Prism Treatment After Acute Stroke (P6.210)

Objective: This translational project piloted evidence-based processes for therapist neglect assessment and treatment in acute stroke care. Background: Post-stroke spatial neglect is common and very costly, impeding functional recovery, and increasing fall risk and caregiver burden. We advocate for early spatial neglect treatment, because of its adverse impact on stroke outcomes. However, most acute-care clinicians are not trained to recognize and address neglect. Methods: At Newark Beth Israel Medical Center, internists oversee care of medically-underserved stroke patients with neurology consultation. After meeting with stroke administrators (planning phase), a researcher-clinician occupational therapy liaison (Hreha) trained and supervised 8 acute-care therapists for 6 months (dissemination phase). Therapists became proficient in the Kessler Foundation Neglect Assessment Process (KF-NAP)and Prism Adaptation Treatment (KF-PAT) with right stroke patients. We 1)compared stroke outcomes during dissemination and implementation to the previous year 2)collected a self-reported survey from therapists 3) tracked neglect assessment and treatment over the next 6 months (implementation phase). Results: During the dissemination and implementation phases, overall stroke patients’ length of stay, 30-day readmissions and in hospital falls/mo declined. During implementation, of 75 patients with right brain stroke, 65 (86.7[percnt]) were assessed with the KF-NAP. Eight (12.3[percnt]) had spatial neglect, and 5 (62.5[percnt]) received 1 or more KF-PAT session: the first US patients, we believe, to receive prism therapy during acute stroke care. After dissemination, therapists were confident (38[percnt]) or somewhat confident (72[percnt]) in spatial neglect assessment. All reported that they would recommend training to colleagues, and agreed that acute neglect assessment and treatment enhances stroke recovery. Conclusions: Fewer patients had spatial neglect than expected, but we demonstrated feasible knowledge translation for spatial neglect care in an underserved setting. An active-learning approach may be key to clinician engagement. Future research in stroke centers will help clarify the impact of neglect assessment and treatment on quality outcomes. Disclosure: Dr. Barrett has received personal compensation for activities with Kessler Foundation as an employee. Dr. Barrett has received research support from SPR therapeutics. Dr. Chen has nothing to disclose. Dr. Hreha has received personal compensation for activities with Kessler Institute for Rehabilitation. Dr. Alban has nothing to disclose. Dr. Gocon has nothing to disclose. Dr. Santos has nothing to disclose. Dr. Lawless has nothing to disclose. Dr. LaRosa has nothing to disclose.