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Irish Journal of Medical Science

, Volume 176, Issue 2, pp 75–79 | Cite as

An audit of the impact of implementation of a stroke care pathway in an acute teaching hospital

  • K. M. Tan
  • B. Austin
  • M. Shaughnessy
  • M. McDonald
  • S. O’Keeffe
  • E. C. MulkerrinEmail author
Original Article

Abstract

Background

In 2002, a survey of stroke management was conducted in our institution benchmarked against the UK National Stroke Audit 2002. The conclusion was that management of stroke patients lacked organised and specialised care. The introduction of a stroke care pathway was recommended.

Aims

This audit assessed the clinical impact of implementation of a stroke care pathway by the general medical teams in an acute teaching hospital.

Methods

A random sample of 48/131 patients were surveyed in 2002 compared to 55 consecutive patients admitted with stroke in 2005.

Results

Despite introduction of a stroke care pathway, marked deficits persisted in acute management including delays in brain imaging and aspirin administration, assessment of acute parameters and interdisciplinary care.

Conclusions

Optimal care of stroke patients cannot be achieved by introducing a stroke care pathway alone. We recommend the urgent establishment of a stroke unit with a specialist consultant-led multidisciplinary stroke team.

Keywords

Acute management Care pathway Multidisciplinary Stroke 

References

  1. 1.
    Stroke Unit Trialists’ Collaboration (2001) Organised inpatient (stroke unit) care for stroke: the Cochrane database of systematic reviews. Issue 3. Art. No.: CD000197. doi:10.1002/14651858.CD000197Google Scholar
  2. 2.
    Crowe M, Delargy M (2000) Hospital services for patients with acute stroke in Ireland: the volunteer stroke scheme survey of consultant opinion. Ir Med J 93(1):15–26PubMedGoogle Scholar
  3. 3.
    Intercollegiate Stroke Working Party (2001/2) Concise report on the National sentinel stroke audit. Clinical Effectiveness and Evaluation Unit, Royal College of Physicians of London, London. http://www.rcplondon.ac.uk/college/ceeu/strokeconciseauditreport.pdf. Accessed 11 December 2005Google Scholar
  4. 4.
    Intercollegiate Stroke Working Party (2004) National clinical guidelines for stroke, 2nd edn. Clinical Effectiveness and Evaluation Unit, Royal College of Physicians of London, London. http://www.rcplondon.ac.uk/pubs/books/stroke/stroke_guidelines_2ed.pdf. Accessed 11 December 2005Google Scholar
  5. 5.
    Garg R, Chaudhuri A, Munschauer F, Dandona P (2006) Hyperglycaemia, insulin, and acute ischaemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke 37(1):267–273PubMedCrossRefGoogle Scholar
  6. 6.
    Gilmore RM, Stead LG (2006) The role of hyperglycaemia in acute ischaemic stroke. Neurocrit Care 5(2):153–158PubMedCrossRefGoogle Scholar
  7. 7.
    Kwan J, Sandercock P (2004) In-hospital care pathways for stroke: the Cochrane database of systematic reviews. Issue 4. Art. No.: CD002924. doi:10.1002/14651858.CD002924.pub2Google Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2007

Authors and Affiliations

  • K. M. Tan
    • 1
  • B. Austin
    • 1
  • M. Shaughnessy
    • 1
  • M. McDonald
    • 2
  • S. O’Keeffe
    • 1
  • E. C. Mulkerrin
    • 1
    • 3
    Email author
  1. 1.Department of Geriatric MedicineGalway Regional HospitalGalwayIreland
  2. 2.Clinical Audit and Accreditation DepartmentGalway Regional HospitalGalwayIreland
  3. 3.Department of Medicine for the ElderlyUCHGalwayIreland

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