Acute Ischemic Stroke Management: A Clinical Audit in Accordance with the 2019 AHA Guidelines

Background and Objective: Acute ischemic stroke (AIS) is one of the leading causes for disability worldwide. Incidence has substantially been on the rise globally including Bahrain. The American Heart Association has proposed their latest recommendations with careful integration of the latest literature to optimize stroke care. The aim of this clinical audit is to determine adherence of King Hamad University Hospital to the latest recommendations provided by the AHA/ASA association in order to evaluate the quality of AIS care and highlight improvements to standard practice. Patients and Methods: A retrospective review of patient records was conducted on 75 eligible patients. Patient charts were analyzed for adherence to a select number of parameters pertinent to the AHA/ASA guidelines. Results: Results indicated high adherence rates ranging from 61.1% to 100% for parameters pertaining to stroke scales, imaging, door to needle times, blood glucose, electrocardiograms and anti-platelet agents. Standards were met in the in-patient setting for the relevant guidelines with the exception of dysphagia and dvt prophylaxis. Conclusion: Dysphagia screening and dvt prophylaxis adherence rates should be improved. Specific recommendations are proposed including checklist implementation, informing patient care staff for prompt dysphagia assessment and integrating latest guidelines into the existing dvt prophylaxis protocol.