Professor Sandy Middleton - Nat Sch of Nursing, Midwifery and Paramedicine (Faculty of Health Sciences)

Fully accredited supervisor - Can supervise as principal supervisor


Evidence-based practice, Health Services research, Stroke, Models of Care. Method: cluster randomised controlled trials, randomised controlled trials, survey methods.


Phone :(02) 8382 3790 (North Sydney)
URIs : Staff Directory Profile

Research Interests

Evidence-Based Practice ; Models of Care ; Health Services Research ; Stroke ; Implementation Science ;

Methods Expertise

Randomized controlled trials ; Clinical audit ; Survey methods ;

Research Projects

Current Projects

  • National Institute for Health Research (UK) Global Health Research Group. (Funded Grant) (Chief Investigator)
  • Transforming nursing assessment in acute hospitals: a cluster randomised controlled trial of an EvideNce-based CORE assessment protocol (the ENCORE study). (Funded Grant) (Chief Investigator)
  • Sydney Partnership for Health, Education, Research & Enterprise (SPHERE) Implementation Science Platform. (Funded Grant) (Chief Investigator)
  • Code Stroke 2.0 (Funded Grant) (Chief Investigator)
  • Post-stroke hyperglycaemia-Treatment with Exenatide in Acute Ischaemic Stroke (TEXAIS) trial. (Funded Grant) (Chief Investigator)
  • Reintegration into the Community to Address patient-centred recovery goals and improve Participation after Stroke (ReCAPS). (Funded Grant) (Chief Investigator)
  • QASC Europe: A proposal to implement and evaluate nurse-initiated evidence-based stroke care in Europe, to manage fever, hyperglycaemia and swallowing difficulties. (Funded Grant) (Chief Investigator)

Selected Publications


Are service and patient indicators different in the presence or absence of nurse practitioners? The EDPRAC cohort studfy of Australian emergency departments. , in BMJ Open

Vital sign monitoring following stroke associated with 90-day independence: a secondary analysis of the QASC cluster randomized trial. , in International Journal of Nursing Studies

A Cluster Randomised Trial for the Detection of New Diabetes based on a System of Routine Glucose Testing in Emergency. , in Medical Journal of Australia

Nurse-initiated acute stroke care in Emergency Departments: Results from the T3 implementation cluster randomised controlled trial. , in Stroke


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. , in Implementation Science

Cluster-Randomized, Crossover trial of head positioning in acute stroke. , in New England Journal of Medicine

Mortality reduction for fever, hyperglycaemia and swallowing nurse-initiated stroke intervention: QASC trial follow-up. , in Stroke


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, in BMJ Open

Better outcomes for hospitalized patients with TIA when in stroke units: An observational study, in Neurology


Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial, in The Lancet

Other information

Total Category 1: $26,091,998

Alexandrov AW, Alexandrov A, Metter E J, Thomas F, Tsivgoulis G, Middleton S. ZerO Degree head positioning In Acute ischemiC stroke (ZODIAC). National Institutes of Health (USA), USD$2,362,361 (AUD$3,334,236).

Bernhardt J, Donnan G, Churilov L, Langhorne P, Pandian J, Dewey H, Srikanth V, English C, Moodie M, Middleton S. AVERT-DOSE (Determining Optimal early rehabilitation after StrokE): A multi-arm covariate-adjusted, response-adaptive randomised controlled trial. NHMRC, $4,359,563.55.

Douglas C, Middleton S, Gardner G, Kelly P, Morton R, McInnes E, Windsor C. Transforming nursing assessment in acute hospitals: a cluster randomised controlled trial of an EvideNce-based CORE assessment protocol (the ENCORE study). NHMRC, $1,069,268.

Westbrook J, Braithwaite J, Day R, Middleton S, Scott D, Rapport F, Mitchell R, Baysari M, Li L, Taylor N. Creating a culture of safety and respect: a controlled, mixed methods study of the effectiveness of a behavioural accountability intervention to reduce unprofessional behaviours (ETHOS). NHMRC, $1,225,978.

Bladin C, Cheung N, Dewey H, Churilov L, Middleton S, Thijs V, Ekinci E. Post-stroke hyperglycaemia-Treatment with Exenatide in Acute Ischaemic Stroke (TEXAIS) trial. NHMRC, $1,266,149.

Bernhardt J, Nilsson M, Carey L, van Vilet P, Cadilhac D, Parsons M, Bladin C, Middleton S, Levi C, Donnan G. Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery. NHMRC, $2,500,537.

2014 - 2016
Arima H, Lavados P, Middleton S, Watkins C, Robinson T, Heritier S, Hackett M, Olavarria V, Heeley, E. Head Position in Stroke Trial (HeadPoST). NHMRC, $1,709,566.

2014 - 2018
Middleton S, Alexandrov A, Watkins C, Cadilhac, D McInnes L.Australian Catholic University - International Stroke Research Collaborative (ACU-ISReC). Australian Catholic University Faculty Research Grant, $ 2,879,428.

2014 - 2016
Spratt N, Ada L, Nilsson M, Middleton S, Bernhardt J, Churilov L, Levi C, Pollack M, Faux S, Perry L, McCluskey A. Altering the Rehabilitation. Altering the Rehabililtation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial. NSW CVRN Research Development, $254,633.

2013 - 2015
Armstrong E, Godeke E, Bernhardt J, Middleton S, Rai T, Holland A. Very Early Rehabilitation in SpEech: An RCT of aphasia therapy after stroke. NHMRC, $742,000.

2012 - 2016
Middleton S, Levi C, Fitzgerald M, Considine J, Grimshaw J, Da??Este C, Gerraty R, Cheung W, Cadilhac D, McInnes E. Associate Investigators: Quinn C, Cadigan G, Ward J, Longworth M, McElduff P, Dale S, Denisenko S. T3 Trial: Triage, Treatment and Transfer of patients with stroke in emergency departments. NHMRC, $2,258,198.

2012 - 2015
Cadilhac D, Anderson C, Donnan G, Levi C, Thrift A, Middleton S, Lannin N, Faux S, Sundararajan V, Grimley R. STROKE123: A collaborative national effort to monitor, promote and improve the quality of stroke care in hospitals and patient outcomes. NHMRC, $1,200,000.

2012 - 2015
Gardner G, Gardner A, Middleton S, Considine J, Hurst C, Della P, Fitzgerald G, Christofis L, Finckh A, Chu K. A prospective evaluation of the impact of the nurse practitioner role on emergency department service and outcomes. ARC, $507,178.

Cheung W, Campbell L, Middleton S, Pollock C, Fulcher G, Watt H, McElduff P. Diabetes Case Detection through Emergency Department Admissions. NHMRC, $160,016.

2010 - 2012
McCluskey A, Ada L, Middleton S, Goodall S, Grimshaw J, Kelly P. The Out-and-About Trial: Improving quality of life by increasing outdoor journeys after stroke. NHMRC, $576,600.