Impact of a stroke admission protocol - A quality improvement project

Manzoor R. Rather, Rohtesh S. Mehta, Ali Akbar, Mohammed Haris Usman

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

• Objective: To assess the impact of a standardized admission protocol for patients with ischemic stroke on stroke-related outcome variables. • Methods: Retrospective chart review conducted on patients admitted with ischemic stroke between January 2003 and December 2007. Student's t test and Pearson chi-square test were used for data analysis using SPSS 16. • Results: Significantly more patients received aspirin at the time of admission (81% vs. 67%; P = 0.036) and received aspirin plus dipyridamole upon discharge (27% vs. 8%; P= 0.001) during the post-intervention period. The use of statins increased severalfold at admission (63% vs. 28%, P < 0.001) and almost doubled (64% vs. 33%) upon discharge in the postintervention phase. The use of ACE inhibitors at discharge also improved appreciably from 38% to 53% in the postintervention phase (P= 0.047). The use of diagnostic studies including MRI of the head, ultrasound of carotid arteries, and 2D echocardiogram showed statistically significant intensification. More frequent DVT prophylaxis in the postintervention phase (76% vs. 55%, P= 0.04) resulted in fewer cases of DVT. Intensive dysphagia screening resulted in a notable reduction of aspiration pneumonia (P= 0.023). • Conclusion: The introduction of a standard admission protocol for ischemic stroke patients can enhance patient care and improve patient outcome by coordinating the management plan at various levels of multidisciplinary care.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalJournal of Clinical Outcomes Management
Volume17
Issue number2
StatePublished - Feb 2010

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