Professor Sandy Middleton

Sandy Middleton is Professor of Nursing and Director of the Nursing Research Institute, a collaboration between St Vincent's Health Australia (Sydney) and Australian Catholic University. She has obtained 80 grants totalling over $AUD45 million. Professor Middleton was the lead investigator on the landmark NHMRC-funded QASC cluster trial demonstrating decreased death and dependency following implementation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing post-stroke, winning multiple international awards. Subsequently, Professor Middleton successfully translated this intervention into all 36 NSW stroke units, winning the 2014 NSW Premier's Public Sector Award for Improving Performance and Accountability, and the 2014 NSW Health Nursing and Midwifery Award for Excellence in Innovation Research - the highest NSW accolade for a nurse researcher. These protocols now are being translated into 300 hospitals in 12 European countries. She has published in high impact journals including Lancet, New England Journal of Medicine, Stroke, Implementation Science, and International Journal of Stroke. Professor Middleton is a Ministerial appointment to the NHMRC Health Translation Advisory Committee (HTAC), and sits on the board of directors for the NSW Agency for Clinical Innovation and the Clinical Excellence Commission. She is leading the implementation science component of the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), one of Australia's 9 Advanced Health Research and Translation Centres.  Her areas of research interest are implementation research, stroke, and cluster randomised controlled trials.

2019

Cadilhac D, Kilkenny M, Lannin N, Dewey H, Levi C, Hill K, Grabsch B, Grimley R, Blacker D, Thrift A, Middleton S, Anderson C, Donnan G. Outcomes for patients with in-hospital stroke: a multicentre study from the Australian Stroke Clinical Registry. Journal of Stroke and Cerebrovascular Diseases 2019. In press. Accepted 26 Jan 2019.

Middleton S, McElduff P, Drury P, D&rsquoEste C, Cadilhac DA, Dale S, Grimshaw J, Ward J, Quinn C, Cheung NW, Levi C. Vital sign monitoring following stroke associated with 90-day independence: a secondary analysis of the QASC cluster randomized trial. International Journal of Nursing Studies 2019 89: 72-79. In Press. [Epub ahead of print] doi.org/10.1016/j.ijnurstu.2018.09.014

Craig LE, Middleton S, Hamilton H, Cudlip F, Swatzell V, Alexandrov AV, Lightbody E, Watkins C, Philip S, Cadilhac DA, McInnes E, Dale S, Alexandrov AW. Does the Addition of Non-Approved Inclusion and Exclusion Criteria for rtPA Impact Treatment Rates? Findings in Australia, the UK, and the USA. Interventional Neurology 20198(1):1&ndash12.  [Epub ahead of print] doi.org/10.1159/000493020

Kilkenny M, Kim J, Andrew N, Sundararajan V, Thrift AG, Katzenellenbogen JM, Flack F, Gattellari M, Boyd JH, Anderson P, Lannin N, Sipthorp M, Chen Y, Johnston T, Anderson CS, Middleton S, Donnan GA, Cadilhac DA. Maximising data value and avoiding data waste: a validation study in stroke research. Medical Journal of Australia 2019 210 (1): 27-31 doi: 10.5694/mja2.12029

Andrew N, Middleton S, Grimley R, Anderson C, Donnan G, Lannin N, Salama E, Grabsch B, Kilkenny M, Squires J, Cadilhac D. Hospital organizational context and delivery of evidence-based stroke care: a cross-sectional study. Implementation Science. 2019 14(6). doi.org/10.1186/s13012-018-0849-z

2018

Godecke E, Rai T, Cadilhac DA, Armstrong E, Middleton S, Ciccone N, Whitworth A, Rose ML, Holland A, Ellery F, Hankey GJ, Bernhardt J for the VERSE Collaboration. Statistical analysis plan (SAP) for the Very Early Rehabilitation in Speech (VERSE) after stroke trial: an international 3-arm clinical trial to determine the effectiveness of early, intensive, prescribed, direct aphasia therapy. International Journal of Stroke 2018 13(8): 863-880. doi: 10.1177/1747493018790055.

Lynch E, Ramanathan S, Middleton S, Bernhard J, Nilsson M, Cadilhac DA. A mixed methods study to explore opinions of research translation held by researchers working in a Centre of Research Excellence in Australia. BMJ Open 2018 8:e022357. [Online publication] doi: 10.1136/bmjopen-2018-022357

Kilkenny M, Lannin N, Levi C, Faux S, Dewey H, Grimley R, Hill K, Grabsch B, Kim J, Hand P, Crosby V, Gardner M, Rois-Gnecco J, Thijs VN, Anderson CS, Donnan G, Middleton S, Cadilhac DA on behalf of the AuSCR Consortium. Weekend hospital discharge is associated with suboptimal care and outcomes: An observational Australian Stroke Clinical Registry study. International Journal of Stroke 2018. 0(0)1&ndash9. [Epub ahead of print] doi: 10.1177/1747493018806165

Malone V, Ezard N, McInnes E, Clifford B, Bonevski B, Middleton S. A systems change intervention for nurse-led smoking cessation care in hospitals. Collegian 2018. In Press. [Epub ahead of print] doi.org/10.1016/j.colegn.2018.07.007.

Busingye D, Kilkenny MF, Purvis T, Kim J, Middleton S, Campbell BCV, Cadilhac DA. Is length of time in a stroke unit associated with better outcomes for patients with stroke in Australia? An observational study. BMJ Open 2018 8(11):e022536. [Online publication] doi: 10.1136/bmjopen-2018-022536

Ramanathan S, Reeves P, Deeming S, Berrnhardt J, Nilsson M, Cadilhac DA, Walker R, Carey L, Middleton S, Lynch E, Searles A. Implementing a protocol for a research impact assessment of the Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery. Health Research Policy and Systems 2018 16(71). In Press. [Epub ahead of print] doi.org/10.1186/s12961-018-0349-2.

Rogers JM, Bechara J, Aminov A, Middleton S, Johnstone SJ. Acute EEG patterns associated with transient ischemic attack. Clinical EEG & Neuroscience 2018.  In Press. [Epub ahead of print] https://doi.org/10.1177/1550059418790708

Morgan P, Coleman P, Martinez-Garduno C, Gunaratne A, McInnes, E, Middleton S. Implementation of a patient blood management program in an Australian private hospital Orthopaedic Unit. Journal of Blood Medicine 2018 9: 83-90. DOI: 10.2147/jbm.s157571

Muller C, Cheung WA, Dewey H, Churilov L, Middleton S, Thijs V, Ekinci E, Levi C, Lindley R, Donnan GA, Parsons M, Bladin C. Treatment with Exenatide in Acute Ischaemic Stroke (TEXAIS) trial Protocol: a prospective, randomised, open label, blinded end-point study of Exenatide vs. Standard Care in Post Stroke Hyperglycaemia. International Journal of Stroke 2018 13(8): 857&ndash862. https://doi.org/10.1177/1747493018784436

Alexandrov AW, Palazzo P, Biby S, Doerr A, Dusenbury W, Young R, Lindstrom A, Grove M, Tsivgoulis G, Middleton S, Alexandrov AV. Back to basics: Adherence with guidelines for glucose and temperature control in an American comprehensive stroke center sample. Journal of Neuroscience Nursing 2018 50(3): 131-137. doi:10.1097/JNN.0000000000000358

Aminov A, Rogers J, Middleton S, Caeyenberghs K, Wilson PH. What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes.  Journal of NeuroEngineering and Rehabilitation 2018 15:29. doi: 10.1186/s12984-018-0370-2

Haines MM, Brown B, D&rsquoEste CA, Yano EM, Craig JC, Middleton S, Castaldi PA, Pollock CA, Needham K, Watt WH, Elliott EJ, Scott A, Dominello A, Klineberg E, Atkinson J, Paul C, Redman S, on behalf of the Clinical Networks Research Group. Improving the quality of healthcare: a cross-sectional study of the features of successful clinical networks. Public Health Research Practice 2018 28 (4)  e28011803 doi.org/10.17061/phrp28011803

Kilkenny MF, Lannin NA, Anderson CS, Dewey H, Kim J, Barclay-Moss K, Levi C, Faux S, Hill K, Grabsch B, Middleton S, Thrift A, Grimley R, Donnan G, Cadilhac D. Quality of life is poorer for patients with stroke who require an interpreter: An observational Australian Registry study. Stroke 2018 49 (3): 761-764. DOI: 10.1161/STROKEAHA.117.019771

Cadilhac DA, Andrew NE, Kilkenny MF, Hill K, Grabsch B, Lannin NA, Thrift A, Anderson CS, Donnan GA, Middleton S, Grimley R. Improving quality and outcomes of stroke care in hospitals: protocol and statistical analysis plan for the Stroke123 implementation study. International Journal of Stroke 2018 13(1): 96-106. doi: 10.1177/174749301773074

Andrew NE, Kim J, Thrift AG, Kilkenny MF, Lannin NA, Anderson CS, Donnan GA, Hill K, Middleton S, Levi C, Faux S, Grimley R, Gange N, Geraghty R, Ermel S, Cadilhac DA.  Prescription of antihypertensive medication at discharge influences survival following stroke. Neurology 2018 90(9): e745-e753. DOI: 10.1212/WNL.0000000000005023

Gardner G, Gardner A, Middleton S, Considine J, Fitzgerald G, Christofis L, Doubrovsky A, Adams M, O&rsquoConnell J. Mapping workforce configuration and operational models in Australian Emergency Departments: A national survey. Australian Health Review 2018 42(3): 340-347. doi: 10.1071/AH16231

2017

Purvis T, Kilkenny MF, Middleton S, Cadilhac DA. Influence of stroke coordinators on delivery of acute stroke care and hospital outcomes: An observational study. International Journal of Stroke 2017 13 (6): 585-591. doi: 10.1177/1747493017741382.

Lannin NA, Anderson CS, Kim J, Kilkenny M, Bernhardt J, Levi C, Dewey H, Bladin C, Hand P, Castley J, Hill K, Faux S, Grimley R, Grabsch B, Middleton S, Donnan G, Cadilhac DA. Treatment and outcomes of working aged adults with stroke: results from a national prospective registry. Neuroepidemiology 2017 49(3-4): 113-120. doi: 10.1159/000484141

Middleton S, Bruch D, Martinez-Garduno C, Dale S, McNamara M. International uptake of a proven intervention to reduce death and dependency in acute stroke: A cross-sectional-survey following the QASC Trial. Worldviews on Evidence-Based Nursing 2017 14(6):447-454. doi: 10.1111/wvn.12253

Luker J, Bernhardt J, Graham I, Middleton S, Lynch E, Thayabaranathan T, Craig L, Cadilhac D, O&rsquoConnor D, Miller P, Tavender E. Interventions for the uptake of evidence-based recommendations in acute stroke settings. Cochrane Database of Systematic Reviews 2017 Issue 1. Art. No.: CD012520. DOI: 10.1002/14651858.CD012520

Aminov A, Rogers JM, Wilson PH, Johnstone SJ, Middleton S. Acute single channel EEG predictors of cognitive function after stroke. PLOS ONE 2017 12(10): e0185841. https://doi.org/10.1371/journal.pone.0185841

Ferguson C, Inglis SC, Newton PJ, Middleton S, Macdonald PS, Davidson PM. Barriers and enablers to adherence to anticoagulation in heart failure with atrial fibrillation: patient and provider perspectives. Journal of Clinical Nursing 2017 26(23-24): 4325-4334. DOI: 10.1111/jocn.13759.

Kawano H, Bivard A, Parsons M, Paul C, Krause M, D&rsquoEste C, Bladin C, Lindley R, Attia J, Henskens F, Longworth M, Middleton S, Ryan A, Kerr E, Sanson-Fisher R, Levi C. Hospital arrival times and post-imaging delays in stroke thrombolysis implementation. Journal of Neurological Disorders & Stroke 2017 5(3): 1127-1132.

Billot L, Woodward M, Arima H, Hackett M, Munoz Venturelli P, Lavados P, Brunser A, Peng B, Cui L, Song L, Heritier S, Jan S, Middleton S, Olavarría V, Lim J, Robinson T, Anderson CS. Statistical analysis plan for the Head Position in Stroke Trial (HeadPoST): an international cluster cross-over randomised trial. International Journal of Stroke 2017 12(6): 667-670.

Westbrook JI, Li L, Hooper TD, Raban MZ, Middleton S, Lehnbom EC. Effectiveness of a &lsquoDo not interrupt&rsquo bundled intervention to reduce interruptions during medication administration: A cluster randomised controlled feasibility study. BMJ Quality & Safety 2017 26: 734-742.

Cadilhac DA, Andrew NE, Salama ES, Hill K, Middleton S, Horton E, Meade I, Kuhle S, Nelson MR, Grimley R, Australian Stroke Clinical Registry Consortium. Improving discharge care: the potential of a new organisational intervention to improve discharge after hospitalisation for acute stroke, a controlled before-after pilot study. BMJ Open 2017 7(8): e016010. DOI: 10.1136/bmjopen-2017-016010

Mikulik R, Ylikotila P, Roine R, Brozman M, Middleton S. Leaving a legacy of Stroke in Europe: A community of dedicated professionals is changing the face of stroke in Europe. Oruen &ndash The CNS Journal 2017 3(1): 8-18.

Craig L, Taylor B, Grimley R, Cadilhac D, McInnes E, Phillips R, Dale S, O&rsquoConnor D, Levi C, Fitzgerald M, Considine J, Grimshaw J, D&rsquoEste C, Gerraty R, Cheung W, Ward J, Middleton S. Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF): The T³ Trial. Implementation Science 2017 12: 88.

Anderson CS, Arima H, Lavados P, Billot L, Hackett ML, Olavarria VV, Munoz-Venturelli P, Brunser A, Peng B, Cui L, Song L, Rogers K, Middleton S, Lim JY, Forshaw D, Lighbody CE, Woodward M, Pontes-Neto O, de Silva A, Lin RT, Lee TH, Pandian JD, Mead GE, Robinson T, Watkins C for the HeadPoST Investigators and Coordinators. Cluster-Randomized, Crossover trial of head positioning in acute stroke. New England Journal of Medicine 2017 376: 2437-2447.

Cadilhac D, Kilkenny M, Levi C, Lannin N, Thrift A, Kim J, Grabsch B, Churilov L, Dewey H, Hill K, Faux S, Grimley R, Castley H, Hand P, Wong A, Herkes G, Gill M, Crompton D, Middleton S, Donnan G, Anderson C. Risk-adjusted mortality rates following stroke by hospital: evidence from the Australian Stroke Clinical Registry (AuSCR). Medical Journal of Australia 2017 206(8): 345-350.

Ferguson C, Inglis S, Newton P, Middleton S, Macdonald P, Davidson P. Multi-morbidity, frailty and self-care: important considerations in treatment with anticoagulation drugs. Outcomes of the AFASTER study. European Journal of Cardiovascular Nursing 2017 16(2), 113-124. DOI:10.1177/1474515116642604

Craig LE, Churilov L, Olenko L, Cadilhac DA, Grimley R, Dale S, Martinez-Garduno C, McInnes E, Considine J, Grimshaw JM, Middleton S. Testing a systematic approach to identify and prioritise barriers to successful implementation of a complex healthcare intervention. BMC Medical Research Methodology 2017 17: 24.

Middleton S, Coughlan K, Mnatzaganian G, Choy N, Dale, S, Jammali-Blasi A, Levi C, Grimshaw J, Ward J, Cadilhac D, McElduff P, Hiller J, D&rsquoEste C. Mortality reduction for fever, hyperglycaemia and swallowing nurse-initiated stroke intervention: QASC trial follow-up. Stroke 2017 48: 1331-1336.

Cadilhac DA, Andrew N, Lannin N, Middleton S, Levi C, Dewey H, Grabsch B, Faux S, Hill K, Grimley R, Wong A, Sabet A, Butler E, Bladin C, Bates T, Groot P, Castley H, Donnan G, Anderson C. Quality of acute care and long-term quality of life and survival: the Australian Stroke Clinical Registry. Stroke 2017 48(4): 1026 &ndash 1032.

Dennis S, Reddel H, Middleton S, Hasan I, Hermiz O, Phillips R, Crockett A, Vagholkar S, Marks G, Zwar N. Barriers and outcomes of an evidence based approach to diagnosis and management of chronic obstructive pulmonary disease (COPD) in Australia: A qualitative study. Family Practice 2017 34(4): 485-490. DOI: 10.1093/fampra/cmw103

2016

Dennis S, Reddel H, Middleton S, Hasan I, Hermiz O, Phillips R, Crockett A, Vagholkar S, Marks G, Zwar N. Barriers and outcomes of an evidence based approach to diagnosis and management of chronic obstructive pulmonary disease (COPD) in Australia: A qualitative study. Family Practice. Published online 30 September 2016.

 

Craig LE, McInnes E, Taylor N, Grimley R, Cadilhac DA, Considine J, Middleton S. Identifying the barriers and enablers for a triage, treatment and transfer clinical intervention to manage acute stroke patients in the emergency department: A systematic review using the theoretical domains framework (TDF). Implementation Science 2016 11: 157.

 

Ferguson C, Hickman LD, Lal S, Newton PJ, Kneebone I, Mcgowan S, Middleton S.  Addressing the stroke evidence-treatment gap. Contemporary Nurse 2016 52(2-3): 253-257.

**Invited Editorial**

 

Middleton S, Levi C, Dale S, Cheung NW, McInnes E, Considine J, D'Este C, Cadilhac DA, Grimshaw J, Gerraty R, Craig L, Schadewaldt V, McElduff P, Fitzgerald M, Quinn C, Cadigan G, Denisenko S, Longworth M, Ward J and T3 Trialist Collaborators. Triage, Treatment and Transfer of Patients with Stroke in Emergency Departments Trial (The T3 Trial): A cluster randomised trial protocol. Implementation Science 2016 11: 139.

 

Muñoz-Venturelli P, Robinson T,  Lavados PM,  Olavarría VV, Arima H, Billot L, Hackett ML, Lim JY, Middleton S, Pontes-Neto O, Peng B, Cui L, Song L, Mead G, Watkins C, Lin R, Lee T, Pandian J, Asita de Silva H, Anderson CS, for the HeadPoST Investigators. Regional Variation in Acute Stroke Care Organisation. Journal of the Neurological Sciences 2016 371: 126-130.

 

Brown B, Haines M, Middleton S, Paul C, D'Este C, Klineberg E, Elliot E on behalf of the Clinical Networks Research Group. Development and validation of a survey to measure features of clinical networks. BMC Health Services Research 2016 16: 531.

 

Zwar N, Bunker J, Reddel H, Dennis S, Middleton S, van Schayck O, Crockett A, Hasan I, Hermiz O, Vagholkar S, Xuan W, Marks G. Early intervention for chronic obstructive pulmonary disease by practice nurse and GP teams: a cluster randomised trial. Family Practice 2016 33(6): 633-670.

 

Jammali-Blasi A, McInnes E, Middleton S. A survey of acute care clinicians&rsquo views on factors influencing hand hygiene practice and actions to improve hand hygiene compliance. Infection, Disease & Health 2016 21: 16-25.

 

Ferguson C, Inglis, CS, Newton PJ, Middleton S, Macdonald PS, Davidson PM. Multimorbidity, frailty and self-care: Important considerations in anticoagulation. Outcomes of the AFASTER study. European Journal of Cardiovascular Nursing 2016 1-12.

 

Cadilhac D, Kim J, Lannin NA, Levi CR, Dewey HM, Hill K, Faux S, Andrew N, Kilkenny MF, Grimley R, Thrift AG, Grabsch B, Middleton S, Anderson CS, Donnan GA. Better outcomes for hospitalized patients with TIA when in stroke units. Neurology 2016 86(22): 2042-2048. Epub 2016 May 4.

 

Godecke E, Armstrong E, Rai T, Middleton S, Ciccone N, Whitworth A, Rose M, Holland A, Ellery F, Hankey G, Cadilhac D, Bernhardt J. A randomised controlled trial of Very Early Rehabilitation in Speech (VERSE) after stroke. International Journal of Stroke 2016 11(5): 586-592.

 

Ferguson C, Inglis SC, Newton PJ, Middleton S, Macdonald PS, Davidson PM. Education and practice gaps on atrial fibrillation and anticoagulation: A survey of cardiovascular nurses. BMC Medical Education 2016 16: 9.

 

McCluskey A, Ada L, Kelly PJ, Middleton S, Goodall S, Grimshaw JM, Logan P, Longworth M, Karageorge A. A behaviour change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams: The Out-and-About trial. International Journal of Stroke 2016 11(4): 425-37. Epub 2016 Feb 23.

 

Middleton S, Lydtin A, Comerford D, Cadilhac DA, McElduff P, Dale S, Hill K, Longworth M, Ward J, Cheung NW, D'Este C on behalf of the QASCIP Working Group and Steering Committee. From QASC to QASCIP: successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pre-test/ post-test study design. BMJ Open 2016 6(5):e011568.

 

Drury P, McInnes E, Hardy J, Dale S, Middleton S. Stroke unit nurse manager&rsquos views of the influence of individual and organisational factors on evidence-based practice: a survey. International Journal of Nursing Practice 2016 22(2):169-78.

 

Middleton S, Gardner A, Della P, Lam L, Allnutt N, Gardner G. How has the profile of Australian Nurse practitioners changed over time? Collegian: The Australian Journal of Nursing Practice, Scholarship and Research 2016 23: 69-77.

 

2015

McInnes E, Haines M, Dominello A, Kalucy D, Jammali-Blasi A, Middleton S, Klineberg E. What are the reasons for clinical network success? A qualitative study of stakeholder views. BMC Health Services Research 2015 15: 497.

 

Middleton S, Grimlely R, Alexandrov A. Triage, Treatment and Transfer: Evidence-based clinical practice recommendations and models of nursing care for the first 72 hours of admission to hospital for acute stroke. Stroke 2015 46: 18-25.

 

McCluskey A, Ada L, Patrick J Kelly PJ, Middleton S, Goodall S, Grimshaw JM, Logan P, Longworth M, Karageorge A. Compliance with Australian guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: An observational cohort study. BMC Health Services Research 2015 15(1): 296.

 

Dale S, Levi C, Ward J, Grimshaw J, Jammali-Blasi A, D' Este C, Griffiths R, Quinn C, Evans M, Cadilhac D, Cheung NW, Middleton S. Barriers and enablers to implementation clinical treatment protocols for fever, hyperglycaemia and swallowing dysfunction in the Quality in Acute Stroke Care (QASC) Project - a mixed methods study. Worldviews on Evidence Based Nursing 2015 12(1): 41-50.

 

Munoz-Venturelli P, Arima H, Lavados P, Brunser A, Peng B, Cui L, Song L, Billot L, Boden E, Hackett ML, Heritier H, Jan S, Middleton S, Olavarria VV, Lim J, Lindley RI, Heeley E, Robinson T, Pontes-Neto O, Lkhamtsoo N, Lin RT, Watkins C, Anderson C. Head Position in Stroke Trial (HeadPoST) &ndash sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for cluster randomized controlled trial. Trials 2015 16: 256.

 

Knowles S, Lawrence T, McInnes E, Elliott D, Hardy J, Middleton S^. Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care: effects of a targeted protocol implementation for nursing and medical staff. BMC Nursing 2015 14: 6.

 

2014

Ferguson C, Inglis SC, Newton PJ, Middleton S, Macdonald PS, Davidson PM. The caregiver role in thromboprophylaxis management in atrial fibrillation: a literature review. European Journal of Cardiovascular Nursing 2014 14(2): 98-107.

 

McInnes E, Phillips R, Middleton S, Gould D. A Qualitative Study of Senior Hospital Managers' Views on Current and Innovative Strategies to Improve Hand Hygiene Compliance. BMC Infectious Diseases 2014 14: 611.

**Editor's Choice**

 

Ferguson C, Inglis SC, Newton PJ, Middleton S, Macdonald PS, Davidson PM. Atrial fibrillation: stroke prevention in focus. Australian Critical Care 2014 27(2): 92-98.

 

Drury P, Levi C, D&rsquoEste C, McElduff P, McInnes E, Hardy J, Dale S, Cheung NW, Grimshaw J, Quinn C, Ward J, Evans M, Cadilhac D, Griffiths R, Middleton S^. Quality in Acute Stroke Care (QASC): Process evaluation of an intervention to improve the management of fever, hyperglycaemia, and swallowing dysfunction following acute stroke. International Journal of Stroke 2014 9(6): 766-776.

 

Chan D, Levi C, Cordato D, O&rsquoRourke F, Chen J. Redmond H, Xu Y, Middleton S, Pollack M, Hankey G. Health Service Management Study for Stroke: A randomised controlled trial to evaluate two models of stroke care. International Journal of Stroke 2014 9: 400-405.

 

Paul C, Levi C, D'Este C, Parsons M, Bladin C, Lindley R, Attia J, Carey M, Henskens F, Lalor E, Longworth M, Middleton S, Ryan A, Kerr E, Sanson-Fischer R. Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice. Protocol for a cluster randomised controlled trial in acute stroke care. Implementation Science 2014 9: 38.

 

Knowles S, McInnes E, Elliot D, Hardy J, Middleton S^. Evaluation of the implementation of a bowel management protocol in Intensive Care: Effect on clinician practices and patient outcomes. Journal of Clinical Nursing 2014 23: 716-730.

 

Drury P, Levi C, McInnes E, Hardy J, Ward J, Grimshaw J, D'Este C, Dale S, McElduff P, Cheung NW, Quinn C, Griffiths R, Evans M, Cadilhac D, Middleton S^. Management of fever, hyperglycaemia and swallowing dysfunction following acute stroke admission in New South Wales (NSW) Australia. International Journal of Stroke 2014 9(1): 23-31.

 

2013

Duff J, Omari A, Middleton S, McInnes E, Walker K. Educational outreach visits to improve venous thromboembolism prevention in hospitalised medical patients: a prospective before-and-after intervention study. BMC Health Services Research 2013 13: 398.

 

Duff J, Walker K, Middleton S, McInnes E. Educational Outreach Visits to improve nurses' use of mechanical venous thromboembolism prevention in hospitalised medical patients. Journal of Vascular Nursing 2013 31(4): 139-149.

 

Middleton S, Lyons N. In reply - Stroke care in Australia: why is it still the poor cousin of health care? Letter to the Editor. Medical Journal of Australia 2013 199(3): 166.

 

Middleton S, Rowley J, Hillege S, Hill K, Churilov L, Allnutt N. Clinical Guidelines for Acute Stroke Management: Which recommendations should remain consensus-based? Journal of Vascular Nursing 2013 31: 72-83.

Ahern T, Gardner A, Gardner G, Middleton S, Della P. Development and inter-rater reliability testing of a telephone interview training program for Australian nurse interviewers. Nurse Education Today 2013 33(5): 470-474.

 

Ferguson C, Inglis S, Newton P, Middleton S. Macdonald P, Davidson T. Atrial fibrillation and thromboprophylaxis in heart failure: The need for patient centered approaches to address adherence. Vascular Health and Risk Management 2013 9: 3&ndash11.

 

McCluskey A, Ada L, Middleton S, Kelly PJ, Goodall S, Grimshaw JM, Logan P, Longworth M, Karageorge A. Improving quality of life by increasing outings after stroke: Study protocol for the Australian Out-and-About trial. International Journal of Stroke 2013 8(1): 54&ndash58.

 

Chan DKY, Cordato D, O'Rourke F, Chan DL, Pollack M, Middleton S, Levi C. Comprehensive stroke units: A review of comparative evidence and experience. International Journal of Stroke. 2013 8(4): 260-264.

 

2012

Sutherland-Fraser S, McInnes E, Maher E, Middleton S^. Peri-operative nurses' knowledge and reported practice of pressure ulcer risk assessment and prevention: A before-after intervention study. BMC Nursing 2012 11: 25.

 

Zwar N, Hermiz O, Hasan I, Comino E, Middleton S, Marks G, Vagholkar S, Wilson S, Xuan W. Care of patients with a diagnosis of chronic obstructive pulmonary disease: a cluster randomised controlled trial. Medical Journal of Australia 2012 197(7): 394-398.

** Editor's Choice **

** Awarded MJA Prize for Excellence in General Practice Research June 2013 **

 

Bunker J, Reddel HK, Dennis S, Middleton S, Van Schayck CP, Crockett AJ, Hasan I, Hermiz O, Vagholkar S, Marks GB, Zwar NA. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse GP teams. Implementation Science 2012 7: 83.

 

Middleton S. Keeping It Simple: The power of three clinical protocols. Journal of Clinical Nursing 2012 21: 3195-3197.

** Invited Editorial **

 

Lannin N, Ada L, Lindley R, McCluskey A, Middleton S, Quinn C, Longworth M. Stroke clinicians&rsquo priorities for stroke research. Journal of Allied Health Sciences and Practice 2012 10: 4.

 

Duff J, Di Staso R, Cobbe KA, Draper N, Tan S, Halliday E, Middleton S, Lam L, Walker K. Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial. BMC Surgery 2012 12: 14.

 

Wright L, Hill K, Berhardt J, Lindley R, Middleton S^. On behalf of the National Stroke Foundation Stroke Guidelines Expert Working Group. Stroke Management &ndash updated recommendations for treatment along the care continuum. Internal Medicine Journal 2012 42(5): 562-9. doi: 10.1111/j.1445-5994.2012.02774.x

 

Middleton S. Doing the Simple Things Well. Collegian 2012 19: 65-66.

** Invited Editorial **

 

Middleton S, D'Este C, Grimshaw J, Ward J, Levi C on behalf on the Quality in Acute Stroke Care (QASC) trial investigators. Invited Authors Reply. The Lancet 2012 379(9824): 1390. [Letter]

 

Middleton S, Levi C, Ward J on behalf on the Quality in Acute Stroke Care (QASC) trial investigators. Quality in Acute Stroke Care trial: Swallow surveillance rates comparable with international data. Letter to the Editor. The Lancet 2012 379(9824): 1389. [Letter]

 

Middleton S. An outcomes approach to stroke care: The importance of teamwork and good nursing care. International Journal of Stroke 2012  7: 224-226.

** Invited Leading Opinion **

 

Haines M, Brown B, Craig J, D&rsquoEste C, Elliott E, Klineberg E, McInnes E, Middleton S, Paul C, Redman S, Yano EM. On behalf of the Clinical Networks Research Group. Determinants of successful clinical networks: The conceptual framework and study protocol. Implementation Science 2012 7:16.

 

McInnes E, Middleton S, Gardner G, Haines M, Haertsch M, Paul C, Castaldi P. How do stakeholders construe desirable outcomes and determinants of success of clinical networks?  A qualitative study. BMC Health Services Research 2012 12: 49.

 

Barnsley L, McCluskey A, Middleton S. What people say about travelling outdoors after their stroke: A qualitative study. Australian Occupational Therapy Journal 2012 59: 71-78.

 

2011

Middleton S, McElduff P, Ward J, Grimshaw J, Dale S, D"Este C, Drury P, Griffiths R, Cheung NW, Quinn C, Evans M, Cadilhac D, Levi C. Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia and swallowing dysfunction in acute stroke improves 90-day outcomes: QASC, a cluster randomised controlled trial. The Lancet 2011 378(9804): 1699-1706. Published online October 12: 1-8. DOI:10.1016/S0140-6736(11)61485-2.

 

***** Commentary also published in The Lancet ***** See:

Wolfe CDA and Rudd AG. Improvement of Care in Acute Stroke Units. The Lancet 2011 378 (9804): 1679. Published online 12 October 2011 DOI:10.1016/S0140-6736(11)61545-6.

 

***** Published in Faculty 1000 (F1000) Library as a result of post-publication peer review which places this work in the library of the top 2% of published articles in biology and medicine available at http://f1000.com/13399002. *****

 

***** Commentary published in  Annals of Internal Medicine ***** See:

Alberts MJ. ACP Journal Club: The Best Evidence for Patient Care. Annals of Internal Medicine 2012 156(3): JC3-09.

 

Middleton S, Levi C, Ward J, Grimshaw J, Griffiths R, D&rsquoEste C, Dale S, Quinn C, Evans M, Cadilhac D, McElduff. Death, Dependency and Health Status 90-Days following hospital admission for acute stroke in NSW. Internal Medicine Journal 2011 41(10): 736-742.

 

Zwar N, Marks G, Hermiz O, Middleton S, Comino E, Hasan I, Vagholkar S, Wilson S. Predictors of Accuracy of Diagnosis of Chronic Obstructive Pulmonary Disease in General Practice. Medical Journal of Australia 2011 195: 168-171.

 

Middleton S, Gardner A, Gardner G, Della P. The status of Australian nurse practitioners: the second national census. Australian Health Review 2011 35: 448&ndash454, available at http://dx.doi.org/10.1071/AH10987.

 

Perry L, Middleton S. An investigation of family carers&rsquo needs following stroke survivors&rsquo discharge from acute hospital care in Australia. Disability and Rehabilitation 2011 33(19-20): 1890-1900.

 

Jammali-Blasi A, McInnes E, Markus R, Faux S, O'Loughlin G, Dale S, Middleton S^. 90-day outcomes for a cohort of patients admitted to a metropolitan acute stroke unit. Journal of Vascular Nursing 2011 29(1): 3-10.

 

Jordan L A, Mackey E, Coughlan K, Wyer M, Allnutt N, Middleton S ^. Continence management in acute stroke: A survey of current national practices. Journal of Advanced Nursing 2011 67(1): 94-104.

 

2010

McMaster R, Hawley R, Fletcher T, Gillett W, McDermott S, Middleton S^. Evaluation of a Housing Support program for people who are at risk of homelessness: Perspective of people who refer clients. Journal of Social Distress and the Homeless 2010 19(3-4): 18-46.

 

Sangvatanakul P, Hillege S, Lalor E, Levi C, Hill K, Middleton S^. Setting stroke research priorities: The consumers' perspective. Journal of Vascular Nursing, 2010 28(4): 121-131.

 

Walker K, Middleton S, Rolley J, Duff J. Nurses report a healthy culture: results of the practice environment scale (PES-AUS) in an Australian hospital seeking magnet recognition. International Journal of Nursing Practice, 2010 16(6): 616-623.

 

Gardner G, Gardner A, Middleton S, Della P, Doubrovsky A. A snapshot of Australian nurse practitioners' extended practice activities. Nurse Practitioner Series 2010 3(1): 8-15.

 

Middleton S, Gardner G, Gardner A, Della P, Gibb M, Millar L. The first Australian nurse practitioner census: A protocol to guide standardised collection of information about an emergent professional group. International Journal of Nursing Practice 2010 16: 517-524.

 

Gardner G, Gardner A, Middleton S, Della P, Kain V, Doubrovsky A. The work of nurse practitioners. Journal of Advanced Nursing 2010 66(10): 2160-2169.

** Editor's Choice **

 

McCluskey A, Middleton S. Increasing delivery of an outdoor journey intervention to people with stroke: A feasibility study involving five community rehabilitation teams. Implementation Science 2010 5: 59.

 

Cadilhac DA, Lannin N, Anderson C, Levi C, Faux S, Price C, Middleton S, Lim J, Thrift A, Donnan G. Protocol and pilot data for establishing the Australian Stroke Clinical Registry (AuSCR). International Journal of Stroke 2010 5(3): 217-226.

 

Gardner G, Gardner A, Middleton S, Gibb M, Della P, Duffield C. Development and validation of a novel approach to work sampling: a study of nurse practitioner work patterns. Australian Journal of Advanced Nursing 2010 27(4): 4-12.

 

Allnutt J, Allnutt N, McMaster R, O&rsquoConnell J, Hillege S, Middleton S^, Della P, Gardner G, Gardner A. Clients' understanding of the role of Nurse Practitioners in Australia. Australian Health Review 2010 34: 59-65.

 

McCluskey A, Middleton S. Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams. BMC Health Services Research 2010 10: 18.

 

Knowles S, Rolls K, Elliott D, Hardy J, Middleton S. Patient care guidelines: A telephone survey of intensive care practices in New South Wales. Australian Critical Care 2010 23: 21-29.

 

2009

Middleton S, Walker K, Leigh T. Why Fellowship?  Peak professional bodies, peer recognition and credentialing in Australia. Collegian 2009 16: 177-183. Available at http://dx.doi.org/10.1016/j.colegn.2009.06.002

 

Gardner A, Gardner G, Middleton S, Della P. The status of Australian Nurse Practitioners: Findings from the first national census. Australian Health Review 2009 33(4): 679-689.

 

Middleton S, Levi C, Ward J, Grimshaw J, Griffiths R, D&rsquoEste C, Dale S, Cheung NW, Quinn C, Evans M, Cadilhac D. Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: A cluster randomised controlled trial of knowledge transfer. Implementation Science 2009 4: 16.

 

Hill K, Middleton S^, O'Brien E, Lalor E. Implementing clinical guidelines for acute stroke management: Do nurses have a lead role? Australian Journal of Advanced Nursing 2009 26(3): 53-58.

 

2008

Gattellari M, Worthington J, Zwar N, Middleton S. The management of non-valvular atrial fibrillation (NVAF) in Australian, general practice: bridging the evidence-practice gap. A national, representative needs assessment survey. BMC Family Practice 2008 9: 62. Available at http://www.biomedcentral.com/1471-2296/9/62

 

Middleton S, Griffiths R, Fernandez R, Smith B. Nursing Practice Environment: How does one Australian hospital compare with Magnet Hospitals? International Journal of Nursing Practice 2008 15(5): 366-372.

 

Zwar N, Hermiz O, Hasan I, Comino E, Middleton S, Vagholkar S, Marks G. A cluster randomised controlled trial of nurse and GP partnership for care of Chronic Obstructive Pulmonary Disease. BMC Pulmonary Medicine 2008 8: 8.

 

Hill K on behalf of the National Stroke Foundation Clinical Guidelines for Acute Stroke Management Expert Working Group (Middleton S, member of Expert Working Group). Australian Clinical Guidelines for Acute Stroke Management 2007. International Journal of Stroke 2008 3: 120-129.

 

Gattellari M, Worthington J, Zwar N, Middleton S. Barriers to the use of anticoagulation for non-valvular atrial fibrillation (NVAF): A representative survey of Australian Family Physicians. Stroke 2008 39: 227-230.

 

Middleton S, Levi C, Dale S. Arrival time to stroke unit as crucial a measure as arrival time to emergency department. Stroke 2008 39(1): 5. (Research letter)

 

2007

Middleton S. Audit or Research? Should nurse practitioners participate in these types of evaluation and what is the difference between them? The Nurse Practitioner Series 2007 2(1).

 

Middleton S, Allnutt J, Griffiths R, McMaster R, O'Connell J, Hillege S. Identifying measures for evaluating new models of nursing care: A survey of NSW Nurse Practitioners. International Journal of Nursing Practice 2007 13: 331-340.

 

Middleton S, Chapman B, Griffiths R, Chester R. Reviewing recommendations of root cause analysis. Australian Health Review 2007 31(2): 288-295.

 

2006 & Earlier

Middleton S, Donnelly N, Harris J, Ward J. Nursing intervention after carotid endarterectomy: a randomised trial of Co-ordinated Care Post Discharge (CCPD) in Schneider Z, Whitehead D, Elliott D, Lobiondo-Wood G, Haber J (Eds). Nursing and Midwifery Research. Methods and Appraisal for Evidence-Based Practice. 3rd Edition. Sydney: Mosby, 2007 (reproduced from Journal of Advanced Nursing 2005 52(3):  250-261.

 

Middleton S, Gattellari M, Harris J, Ward J. Assessing surgeons&rsquo disclosure of risk information before carotid endarterectomy. Australian and New Zealand Journal of Surgery 2006 76: 618-624.

 

Gattellari M. Worthington JM, Zwar NA, Middleton S. Barriers to the use of Warfarin in non-valvular atrial fibrillation. British Medical Journal 2006 332: 303-304. (Research letter). Available at http://bmj.bmjjournals.com/cgi/eletters/332/7534/141#126929

 

Middleton S, Walker C, Chester R. Implementing root cause analysis in an area health service: views of the participants. Australian Health Review 2005 29(4): 422-428.

 

Middleton S, Donnelly N, Harris J, Ward J. Nursing intervention after carotid endarterectomy: A randomised trial of Co-ordinated Care Post Discharge (CCPD).  Journal of Advanced Nursing, 2005 52(3): 250-261.

 

Middleton S, Girgis S, Appleberg M, Ward J. Effective discharge policy: are we getting there? Australian Health Review 2004 28(3): 255-259.

 

Middleton S, Harris J, Sharpe D, Corbett A, Lubsy R, Ward J. Improving stroke outcomes in Australia: a study of GP perspectives. Australian Journal of Primary Health 2004 10(2): 21-28.

 

Middleton S, Sharpe D, Harris J, Corbett A, Lusby R, Ward J. Case scenarios to assess Australian general practitioners&rsquo understanding of stroke diagnosis, management and prevention. Stroke 2003 34(11): 2681-2686.

 

Middleton S, Harris J, Lusby R, Ward J. GPs&rsquo views of quality initiatives to improve stroke outcomes following CEA. Australian Family Physician 2003 32(10): 858-861.

 

Middleton S, Harris J, Lusby R, Ward J. Vascular disease risk factor management four years after carotid endarterectomy: Are opportunities missed? Australian and New Zealand Journal of Surgery 2003 73: 225-231.

 

Middleton S, Ward J. Contamination of interventional research is possible through GP membership of more than one Division. Australian Family Physician 2003 32: 95-96.

 

Middleton S, Donnelly N, Ward J. The Avoid Stroke as Soon as Possible (ASAP) general practice stroke audit. Medical Journal of Australia 2002 177: 398-399. (Research letter).

 

Middleton S, Donnelly N, Harris J, Lusby R, Ward J. Audit of longterm mortality and morbidity outcomes for carotid endarterectomy. Australian Health Review 2002 25(4):  81-91.

 

Middleton S, Donnelly N. Outcomes of carotid endarterectomy: How does the Australian state of New South Wales compare with international benchmarks? Journal of Vascular Surgery 2002 36: 62-9.

 

Middleton S, Ward J. Are there commonalities among audit tools used to measure carotid endarterectomy outcomes in NSW? Australian and New Zealand Journal of Surgery 2002 72(1): 21-24.

 

Picone D, Lawler J, Lumby J, Waters D, Hathaway V, Middleton S, Hill H. Clinical practice guidelines for major colorectal surgical procedures. The Journal of Stomal Therapy Australia 2000 20(4): 6-12.

 

Middleton S, Lumby J. Comparing professional and patient outcomes for the same episode of care. Australian Journal of Advanced Nursing 1999  17(1):  22-27.

 

Middleton S, Lumby J. Measuring outcomes from the patients&rsquo perspective. International Journal of Nursing Practice 1999 5(3): 143-146.

 

Middleton S, Lumby J. Outcomes evaluation in nursing in Australia, 1960-1980. Australian Health Review 1998 21(4): 72-79.

 

Middleton S, Lumby J. Exploring the precursors of outcome evaluation in Australia: Linking structure, process and outcome by peer review. International Journal of Nursing Practice 1998 4(3): 151-155.

RESEARCH EXPERTISE

• Implementation Research
• Health Services Research 
• Stroke
• Evidence Based Practice
• Models of Care

Evidence-based practice

Quantitative research methods

Health Services research

Current Professional Responsibilities

Member, National Health and Medical Research Council (NHMRC) Health Translation Advisory Committee (HTAC), 2018 to 2021.

Chair, Implementation Science Platform Committee for Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), NHMRC accredited Advanced Health Research Translation Centre, 2018 to present.

Member, Translational Research Fellowship Committee for Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), NHMRC accredited Advanced Health Research Translation Centre, 2018 to present.

Member, Translation Committee for Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), NHMRC accredited Advanced Health Research Translation Centre, 2018 to present.

Member, Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), NHMRC accredited Advanced Health Research Translation Centre, 2018 to present.

Member, NSW Agency for Clinical Innovation Stroke Service NSW Executive Committee, July 2018 to present.

Chair, NSW Agency for Clinical Innovation Stroke Service NSW Data and Benchmarking Committee, July 2018 to present.

Member, NSW Health Stroke Ambulance Pilot Working Group, 2018 to present.

Chair, NSW Health Stroke Ambulance Research Sub-committee, 2018 to present.

Member, European Stroke Organisation Conference (ESOC), 2018 Allied Health (and Nursing) Sub-committee.

Member, American Heart Association Nursing Symposium Scientific Committee 2018, 2019.

Member, Royal Australasian College of Surgeons Clinical Academic Pathways Working Group (representing Australian College of Nursing), 2018 to present.

Member, St Vincents Health Australia Clinical Assurance and Reliability Program (SCARP) Steering Committee, 2018 to present.

Member, Stroke Foundation, Living Guidelines Stroke Development Working Group, 2018 to present.

Co-Chair, Stroke Foundation, Living Guidelines Stroke Development Nursing Sub-committee Working Group, 2018 to present.

Member, World Stroke Organisation Education Committee, 2017 to present.

Member, Executive Committee for the TEXAIS trial, 2017 to present.

Member, St Vincent's Health Sydney Local Health District, Nursing Advisory Council, October 2015 to present.

Member, AuSDaT Coordinating Committee Working Group, 2015 to present.

Member, National Stroke Foundation (NSF) Stroke Guidelines Development Working Group, 2015 to present.

Co-Chair Nursing Working Group 2017 Acute Stroke Clinical Practice Guidelines.

Member, Agency for Clinical Innovation Board of Directors, March 2014 to present.

Member, Clinical Excellence Commission Board of Directors, March 2014 to present.

International Stroke Conference abstract reviewer, 2013 to present.

Member, Australian Stroke Coalition Data and Quality Working Group Committee, 2013 to present.

Member, National Health and Medical Research Council Research Translation Faculty, 2012.

Member, Agency For Clinical Innovation Research Committee, November 2011 to present.

Member, Clinical Excellence Commission Research Committee, November 2011 to present.

Member, St Vincent's Health Network Research Advisory Council (formerly called St Vincent's Translational Research Steering Committee), September 2011 to present.

Chair, Australian Clinical Stroke Registry Steering Committee, October 2008 to present.

Co-Chair, Working Group. Australian Stroke Coalition. First 48 hours post-stroke Models of Care Project, Jan 2012 to present.

Member, Steering Committee and Member Expert Advisory Committee. Thrombolysis Implementation Plan for Stroke (TIPS). NHMRC funded Cluster randomized controlled trial, July 2010 to present.

Member, St Vincent's Clinic Foundation. Medical Grant Review Panel, 2007 to present.

Chair, Quality in Acute Stroke Care Project Advisory Group, 2004 to present.

Chair, Outcomes Committee. AVERT Trial.  A multi-site NHMRC-funded randomized controlled trial of early mobilization following stroke, November 2006 to April 2015.

Member, Agency for Clinical Innovation (previously the Greater Metropolitan Clinical Taskforce) Stroke Co-ordinating Committee, August 2005 to present.

Member, Agency for Clinical Innovation (previously the Greater Metropolitan Clinical Taskforce) Stroke Research Working Group, Sept 2004 to present.