Evaluation of stroke management in an Irish university teaching hospital: the Royal College of Physicians stroke audit package

Background There are few data regarding the standard of stroke care in Irel and. Aim To investigate the level of documentation for 13 key areas of stroke ma nagement. Methods Using a validated stroke audit package, this study reviewed the med ical records of 100 consecutive patients hospitalised with acute stroke. Results Documentation of stroke symptoms, risk factors, general examination and investigations (cranial computer tomography [CT] and carotid Dopplers) were satisfactory. Neurological documentation was variable, with power (87 %), sensation (70%) and eye movements (63%) being the most frequently recor ded features, while cognition (3%), visual fields (13%), gait (7%), inconti nence (1%) and swallowing (0%) were infrequently recorded. Diagnostic formu lation and an acute management plan were documented in less than half of pa tients, whereas cranial CT (93%) and carotid Dopplers (93%) were well docum ented. Secondary preventive measures were documented in two-thirds of patie nts at follow-up. Conclusions These results serve as a baseline from which to initiate and mo nitor improvements in the service at our hospital, including the involvemen t of neurologists in stroke care, and will also allow assessment of the imp act of such changes.