Physiotherapy alignment with guidelines for the management of stroke in the inpatient setting

Abstract

Clinical guidelines provide a summary of published research to aid the delivery of evidence-based health care. Although alignment with clinical guidelines is associated with positive outcomes in stroke care, there is a lack of evidence to show that physiotherapy management is aligned with the New Zealand Clinical Guidelines for Stroke Management 2010. A retrospective audit was performed on the clinical records of 101 patients discharged from a public hospital in the Auckland region with a diagnosis of stroke in 2012. Issues of management were identified and recorded as in alignment with the guidelines or not. Results showed wide variation in areas of alignment. The highest overall alignment was for management of shoulder pain (100%) and follow up physiotherapy (99%). The alignment with guidelines for activity related limitations (sitting balance, sit to stand, standing balance, walking/mobility, difficulties with activities of daily living, and upper limb functional deficits) were consistently addressed, with a focus on lower limb function and mobility. Recommendations with lower levels of evidence and for issues which do not appear to be a primary functional problem had lower alignment. Ongoing audit cycles would be useful to provide setting specific information of stroke management for improving stroke care.