What are the components of effective stroke unit care?
Langhorne P., Pollock A., Asplund K., Berman P., Blomstrand C., Dennis M., Douglas J., Erila T., Garraway M., Hamrin E., Hankey G., Ilmavirta M., Indredavik B., Kalra L., Kaste M., Laursen SO., Patel N., Rodgers H., Ronning OM., Sivenius J., Stevens R., Stone SP., Svensson A., Williams B., Wood-Dauphinee S.
Background: The effectiveness of organized inpatient (stroke unit) care has been demonstrated in systematic reviews of clinical trials. However, the key components of stroke unit care are poorly understood. Methods: We conducted a survey of recent trials (published 1985-2000) of a stroke unit/ward which had demonstrated a beneficial effect consistent with the stroke unit systematic review. Results: We identified 11 eligible stroke unit trials of which the majority described similar approaches to i) assessment procedures (medical, nursing and therapy assessments), ii) early management policies (e.g. early mobilization; avoidance of urinary catheterization; treatment of hypoxia, hyperglycaemia and suspected infection), iii) ongoing rehabilitation policies (e.g. co-ordinated multidisciplinary team care, early assessment for discharge). Conclusions: This survey provides a description of stroke unit care which can serve as a benchmark for general stroke patient care and future clinical research.