Characteristics of stroke units and stroke teams in Spain in 2018. Pre2Ictus project

M Alonso de Leciñana; A Morales; M Martínez-Zabaleta; Ó Ayo-Martín; L Lizán; M Castellanos; en representación de los investigadores del Proyecto Ictus, GEECV-SEN

doi:10.1016/j.nrl.2020.06.012

Characteristics of stroke units and stroke teams in Spain in 2018. Pre2Ictus project

Neurologia (Engl Ed). 2020 Sep 8:S0213-4853(20)30222-X. doi: 10.1016/j.nrl.2020.06.012. Online ahead of print.

[Article in English, Spanish]

Authors

M Alonso de Leciñana¹, A Morales², M Martínez-Zabaleta³, Ó Ayo-Martín⁴, L Lizán⁵, M Castellanos⁶; en representación de los investigadores del Proyecto Ictus, GEECV-SEN

Affiliations

¹ Servicio de Neurología, Centro de Ictus, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, España. Electronic address: malecinanacases@salud.madrid.org.
² Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
³ Servicio de Neurología, Hospital Universitario de Donostia, San Sebastián, España.
⁴ Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España.
⁵ Outcomes'10 SLU, Castellón, España; Departamento de Medicina, Universitat Jaume I, Castellón, España.
⁶ Servicio de Neurología, Hospital Universitario e Instituto de Investigación Biomédica, La Coruña, España.

PMID: 32917435
DOI: 10.1016/j.nrl.2020.06.012

Abstract

Introduction: The aim of this work is to describe the characteristics of stroke units and stroke teams in Spain.

Method: We performed a cross-sectional study based on an ad hoc questionnaire designed by 5 experts and addressed to neurologists leading stroke units/teams that had been operational for ≥ 1 year.

Results: The survey was completed by 43 stroke units (61% of units in Spain) and 14 stroke teams. The mean (SD) number of neurologists assigned to each unit/team is 4±3. 98% of stroke units (and 38% of stroke teams) have a neurologist on-call available 24hours, 365 days. 98% of stroke units (79% of stroke teams) have specialised nurse, 95% of units (71% of stroke teams) auxiliary personnel, 86% of units (71% of stroke teams) social worker, 81% of stroke units (71% of stroke teams) have a rehabilitation physician and 81% of stroke units (86% of stroke teams) a physiotherapist. Most stroke units (80%) have 4-6 beds with continuous non-invasive monitoring. The mean number of unmonitored beds is 14 (8) for stroke units and 12 (7) for stroke teams. The mean duration of non-invasive monitoring is 3 (1) days. All stroke units and 86% of stroke teams have intravenous thrombolysis available, and 81% of stroke units and 21% of stroke teams are able to perform mechanical thrombectomy, whereas the remaining centres have referral pathways in place. Telestroke systems are available at 44% of stroke units, providing support to a mean of 4 (3) centres. Activity is recorded in clinical registries by 77% of stroke units and 50% of stroke teams, but less than 75% of data is completed in 25% of cases.

Conclusions: Most stroke units/teams comply with the current recommendations. The systematic use of clinical registries should be improved to further improve patient care.

Keywords: Calidad asistencial; Care quality; Dotación; Equipment; Ictus; Organización; Recursos; Resources; Service organisation; Stroke; Telemedicina; Telemedicine.