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THE STROKE REFERRAL PATHWAY IN THE ROYAL BROMPTON HOSPITAL U2013 A TERTIARY CARDIOLOGY CENTRE

出版	2017
URL	http://books.google.com.hk/books?id=5Rm0zQEACAAJ&hl=&source=gbs_api

註釋Background and Aims:Acute stroke is a known complication after cardiac catheterisation and surgery (incidence up to 7% and 5.2% respectively). Given the frequent use of anticoagulation in these patients, there have been limited options for treatments historically. The advent of mechanical thrombectomy has revolutionised stroke care in groups previously ineligible for intervention. As the Royal Brompton Hospital is a stand-alone specialist cardiac centre, it is fundamental that clinicians are aware of the pathway and able to follow it easily in order to expedite care.Methods:The local stroke pathway was analysed and incorporated into an easy to follow pro-forma. A sample of clinicians were surveyed to assess awareness of the pathway, and showed significant gaps in knowledge. An information dissemination campaign was launched involving word of mouth updates, departmental teaching and distribution of the proforma. Clinicians were re-surveyed and results were analysed with Fisheru2019s exact test to assess for significant improvement.Results:Following the campaign, awareness of the pathway improved. Knowledge of the thrombectomy service and the appropriate referral information required improved from 47% to 93% (p=0.0142) and 40% to 90% (p=0.0052) respectively. Knowledge of the ROSIER tool (used in the pathway) rose from 20% to 87% (p=0.0007). Understanding that a CT head should not be done locally, but at the HASU instead improved from 35% to 100% (p