Audit of Stroke Unit Admissions to A University Teaching Hospital (2022–2024)

Abstract Background Stroke is a leading cause of death and disability in Ireland, with rising hospital admissions. Evidence shows stroke unit care improves outcomes. The National Stroke Strategy 2022–2027, recommends that 90% of stroke patients should be admitted to a stroke unit for at least 90% of their hospital stay. This retrospective audit evaluates the performance of a university teaching hospital in meeting this benchmark (2022-2024). Methods A retrospective audit was conducted using data from all stroke admissions from 2022 to 2024. A total of 1,644 cases were extracted from the hospital stroke registry to which data is input from both the institutional stroke audit portal and the Hospital In-Patient Enquiry system. The analysis focused on how many patients were admitted to the stroke unit and the percentage of their hospital stay spent there. Reasons for non-admission were also categorised. Results From 2022 to 2024, annual stroke admissions to a university teaching hospital were 512, 561, and 571 respectively; with stroke unit admission rates of 66%, 69%, and 64%. Of these, 39%, 36%, and 40% stayed in the stroke unit for at least 90% of their hospital stay. The main barrier to stroke unit admission was lack of bed availability, followed by infection control requirements, and other clinical decisions such as ICU/palliative care requirements. Conclusion Stroke admissions are rising each year in tandem with an ageing demographic. The proportion of patients admitted to a stroke unit for some or more than 90% of their hospital stay remains below the national target. The most significant ongoing challenge is limited bed access, resulting in demand exceeding available capacity by a factor of two. Expansion of bed capacity, including the re-designation and appropriate resourcing of non-stroke unit beds, is essential. Infrastructure that enables effective patient isolation is critical to support infection control measures.