Five Years of Acute Stroke Unit Care: Comparing ASU and Non-ASU Admissions and Allied Health Involvement

Abstract

Background. Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU) provides specialised, hyperacute care and thrombolysis. John Hunter Hospital, Australia, admits 500 stroke patients each year and has a 4-bed ASU. Aims. This study investigated hospital admissions over a 5-year period of all strokes patients and of all patients admitted to the 4-bed ASU and the involvement of allied health professionals. Methods. The study retrospectively audited 5-year data from all stroke patients admitted to John Hunter Hospital (n = 2525) and from nonstroke patients admitted to the ASU (n = 826). The study's primary outcomes were admission rates, length of stay (days), and allied health involvement. Results. Over 5 years, 47% of stroke patients were admitted to the ASU. More male stroke patients were admitted to the ASU (chi2 = 5.81; P = 0.016). There was a trend over time towards parity between the number of stroke and nonstroke patients admitted to the ASU. When compared to those admitted elsewhere, ASU stroke patients had a longer length of stay (z = −8.233; P = 0.0000) and were more likely to receive allied healthcare. Conclusion. This is the first study to report 5 years of ASU admissions. Acute Stroke Units may benefit from a review of the healthcare provided to all stroke patients. The trends over time with respect to the utilisation of the John Hunter Hospitall's ASU have resulted in a review of the hospitall's Stroke Unit and allied healthcare.

Care of the Patient With Acute Ischemic Stroke (Posthyperacute and Prehospital Discharge): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association

“…Patients who have had a stroke and receive organized inpatient care in a stroke unit from an interprofessional team who specialize in stroke management are more likely to be alive, independent, and living at home 1 year after stroke. 6,7 This effect could be attributed to staff expertise, better diagnostic procedures, high-quality nursing care, early mobilization, the prevention of complications, or more effective rehabilitation procedures. 7 Health care providers should consider developing standardized stroke care order sets or pathways to guide patient care decisions that lead to high-quality care for patients experiencing acute ischemic stroke.…”

“…The strongest evidence supporting the value of stroke unit care is apparent in outcomes relating to mortality, 8 function, 7 and return to home. 6 There is emerging evidence for other patient-reported outcomes such as health-related quality of life and patient-reported experience outcomes. 7,10…”