Stroke unit creation and management: Barriers and enablers

Abstract

Background: Stroke unit care is the major evidence-based intervention for stroke management within the hospital system. There remain significant numbers of stroke patients who do not receive stroke unit care. Aim(s): To present a summary of the identified barriers and enablers to the creation and running of stroke units in a variety of settings and engage workshop participants in discussion. An awareness of the potential impediments to stroke unit implementation as well as successful outcomes in this regard may assist clinicians and health services in developing stroke units in their settings. Method(s): Experiences of the authors as well as the results of a survey of acute stroke nurses and other clinicians will assist in the identification of barriers and enablers in creating and managing stroke units in regional and metropolitan settings across Australia. Result(s): Survey results will be presented at Smart Strokes 2013, with respondents expected to identify barriers to stroke unit creation ranging from issues of awareness, lack of local commitment and support, resource scarcity, geographic isolation and an inconsistent direction at departmental level. Additionally, different settings are faced with varying challenges associated with effective stroke unit management including maintaining high access rates to stroke units, meeting targets for early assessments and access to rehabilitation, and sustaining staffing and skill levels of the stroke team. Conclusion(s): Collaborative efforts involving all stakeholders across hospitals, departments and organisations at a regional, state and national level appear to offer the best opportunity for further stroke unit development and their effective management.