Stroke audit in a New Zealand hospital

Aims. This study was designed to test the Royal College of Physicians Stroke Audit Package in a general hospital in New Zealand, to identify the strengths and weaknesses of the package and to determine its applicability to the New Zealand environment, A secondary aim was to identify strengths and weaknesses in the process of stroke care at Hutt Hospital. Methods. A retrospective case-note review of 50 consecutive discharges with a diagnosis of stroke or intracerebral haemorrhage. Results. The Royal College of Physicians (RCP) Stroke Audit Package proved easy to use, The hospital audit revealed significant weaknesses in evaluation of stroke patients with inadequate documentation in the medical notes of important items including heart rate and rhythm (58%), blood pressure (74%), visual field assessment (33%), ability to swallow (2%) and conscious level (68%). Conclusions. The RCP Stroke Audit Package is a simple, validated and potentially valuable tool for stroke audit in New Zealand hospitals. Using it, deficiencies in the process of stroke care can be readily identified, improvements made, and the results re-audited to demonstrate change.