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

• Published in: Neurología (Barcelona, English ed. ) Vol. 38; no. 3; pp. 173 - 180
• Main Authors: Alonso de Leciñana, M., Morales, A., Martínez-Zabaleta, M., Ayo-Martín, Ó., Lizán, L., Castellanos, M.
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España, S.L.U 01.04.2023; Elsevier España
• Subjects: Calidad asistencial; Care quality; Cross-Sectional Studies; Dotación; Humans; Ictus; Organización; Recursos; Resources; Service organisation; Spain; Stroke; Stroke - therapy; Surveys and Questionnaires; Telemedicina; Telemedicine; Spain; Care quality; Telemedicina; Recursos; Stroke; Dotación; Service organisation; Equipment; Telemedicine; Organización; Resources; Ictus; Calidad asistencial
• ISSN: 2173-5808; 2173-5808
• DOI: 10.1016/j.nrleng.2022.03.001

The aim of this work is to describe the characteristics of stroke units and stroke teams in Spain. 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. The survey was completed by 43 stroke units (61% of units in Spain) and 14 stroke teams. A mean (standard deviation) of 4 (3) neurologists were assigned to each stroke unit/team; 98% of stroke units (and 38% of stroke teams) have an on-call neurologist available 24 hours a day, 98% of units (79% of stroke teams) included specialised nurses, 86% of units (71% of stroke teams) included a social worker, and 81% of units (71% of stroke teams) included a rehabilitation physician. Most stroke units (80%) had 4--6 beds with continuous non-invasive monitoring. The mean number of unmonitored beds was 14 (8) for stroke units and 12 (7) for stroke teams. The mean duration of non-invasive monitoring was 3 (1) days. All stroke units and 86% of stroke teams had intravenous thrombolysis available, and 81% of stroke units and 21% of stroke teams were able to perform mechanical thrombectomy, whereas the remaining centres had referral pathways in place. Telestroke systems were in place 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. Most stroke units/teams comply with the current recommendations. The systematic use of clinical registries should be improved to further improve patient care. El objetivo del trabajo es describir las características de las unidades (UI) y equipos (EI) de ictus en España. Estudio transversal basado en un cuestionario ad-hoc, diseñado por 5 expertos y dirigido a los neurólogos responsables de las UI/EI con al menos un año de funcionamiento. Participaron 43 UI (61% del total) y 14 EI. La media (±DE) de neurólogos adscritos a las UI/EI es de 4 ± 3. 98% de las UI frente a 38% de EI cuentan con neurólogo de guardia 24 h/7d. Disponen de enfermería especializada 98% de las UI frente a 79% de los EI, de médico rehabilitador 81% frente a 71% y de trabajador social 86% frente a 71%. La mayoría de UI (80%) tienen 4-6 camas con monitorización continua no invasiva. El número medio de camas no monitorizadas de las UI es de 14 ± 8 y de 12 ± 7 en los EI. La estancia media de los pacientes en las camas monitorizadas de las UI es de 3 ± 1 días. Todas las UI y el 86% de EI pueden realizar trombólisis intravenosa; el 81% de UI y 21% de EI trombectomía mecánica; el resto de los centros tiene posibilidad de derivación. El 44% de UI dispone del sistema teleictus, dando soporte a 4 ± 3 centros. La actividad se recoge sistemáticamente en el 77% de UI y 50% de EI, pero su cumplimentación es < 75% en un 25% de los casos. La mayoría de las UI y de los EI cumple las recomendaciones actuales. Para seguir mejorando la atención del paciente, resulta necesario optimizar el registro sistemático de su actividad.