Improved quality of stroke care after multidisciplinary training

Introduction

Stroke continues to have a devastating impact on public health, and it remains a leading cause of death and disability. Unfortunately, it is possible to find prehospital and hospital approaches that do not treat this pathology as a true medical emergency. Hospitals providing care for patients with acute stroke should organize clinical protocols and pathways for effective implementation of acute therapies.

Methods

The survey was conducted in a new secondary hospital in São Paulo, Brazil from May 2008 to December 2008. A retrospective study of the medical records of patients with stroke diagnosis analyzing clinical treatment given before and after a training course (administered in August 2008) provided to medical staff and nurses that work in the Accident and Emergency Department. Median times from admission to head CT, prescription of aspirin, statins and deep venous thrombosis prophylaxis were the indicators evaluated.

Results

Before the training, the median time between admission and the first CT scan was 3 hours; aspirin was prescribed for 63.3% of the patients and statins for 5.3%. Deep venous thrombosis prophylaxis was used only in 36.3% of eligible patients. After theoretical and practical training administered in the Albert Einstein Realistic Simulation Center, the timing for brain imaging had decreased to 1.33 hours, 85.9% of patients had received aspirin and 28.6% had taken statin. Deep venous thrombosis prophylaxis had been provided to 45.88% of eligible patients.

Conclusion

The present study shows that training and monitoring are important for efficiency and the best results for stroke. We conclude that continuous education involving multidisciplinary teams improves the quality of care for patients.