FEWER THAN half of stroke patients are involved in decisions about their care and treatment while in hospital, the first national audit of stroke care has found.
A key element of the Irish National Audit of Stroke Care 2007 was a survey of the experiences of patients who had had a stroke. Questionnaires were also completed by the stroke victims' primary carer. The 200 patients surveyed were looked after in Mayo General Hospital, Mallow General Hospital, Midlands Regional Hospital in Mullingar and Tallaght hospital.
While 78 per cent of respondents said they had been admitted to hospital promptly, almost a half experienced delays between arriving at the hospital emergency department and admission to a ward. Almost a third of patients stated their stroke diagnosis was not discussed with them.
While in hospital, of those who had difficulty swallowing, 33 per cent did not get help when they needed it. In addition, 35 per cent of those stroke patients who developed speech and communication difficulties were not helped.
These statistics reflect, in part, the shortage of speech therapists and other allied health professionals and the absence of stroke units. Deficiencies in pre-discharge planning were also evident, with three-quarters of patients reporting that no family conference was suggested or took place before the patient left hospital.
In relation to the medication they were given at the time of discharge, 70 per cent of patients said they were not informed about the potential side effects.
Over a third of stroke patients were never given information in relation to follow-up services available to them when they got home. Even where follow-up services, such as home help, physiotherapy and occupational therapy, were organised by the hospital, some 24 per cent said none of the services ever materialised. Seventy per cent of those who said they had emotional difficulties after leaving hospital reported not getting enough help.
"Patients and their carers highlighted the need to have a 'central' person with whom they could get in contact if needed," the report says. "The lack of follow-up once they came home was highlighted and many patients reported feeling isolated once they came home and do not know how to address this."
The text of the IHF report is available at: www.ireland.com/focus