Roberts M A, Allen A, Langhorne P, McEwen J, D'A Semple P
Victoria Infirmary, Glasgow.
Health Bull (Edinb). 2000 Mar;58(2):87-95.
An audit was undertaken of hospital service provision for acute strokes in Scotland, using as a template key recommendations in the four SIGN guidelines on management of stroke. A questionnaire and structured interview was undertaken of key personnel in the 43 Trusts and three directly managed units providing in-patient stroke care in Scotland, and the 15 Health Boards commissioning stroke care. All Trusts and Health Boards participated and a complete set of information for each was recorded on a data-base and analysed. This report gives an overview for 14 key components of an integrated stroke service with results presented in four bands according to Trust type determined by the number of strokes admitted. No Trust provided all key components and for a few components a lack of provision was widespread, e.g. fast-track assessment clinics for TIA and minor stroke, access to CT scanning within 48 hours. Variation occurred between Trusts of similar size, between Trusts of different sizes. Overall the Health Boards were at a preliminary stage in the development of stroke specific service specifications. The results of the audit are a view of stroke services around April 1998, and should enable commissioners and providers to consider how to progress implementation of the clinical guidelines on stroke care.
以苏格兰校际指南网络（SIGN）关于中风管理的四份指南中的关键建议为模板，对苏格兰急性中风的医院服务提供情况进行了一次审核。对苏格兰提供住院中风护理的43个信托机构和三个直接管理单位以及委托提供中风护理的15个卫生委员会的关键人员进行了问卷调查和结构化访谈。所有信托机构和卫生委员会均参与其中，并将每个机构的完整信息记录在数据库中进行分析。本报告概述了综合中风服务的14个关键组成部分，并根据中风入院数量确定的信托类型，将结果分为四个等级呈现。没有一个信托机构提供所有关键组成部分，而且对于一些组成部分，供应不足的情况很普遍，例如短暂性脑缺血发作（TIA）和轻度中风的快速评估诊所、48小时内进行CT扫描的机会。规模相似的信托机构之间、不同规模的信托机构之间存在差异。总体而言，卫生委员会在制定中风特定服务规范方面尚处于初步阶段。审核结果反映了1998年4月左右的中风服务情况，应能使委托方和提供方考虑如何推进中风护理临床指南的实施。
