Enhancing emergency stroke care: NICE guideline adherence in an Indian tertiary care hospital

<h3></h3> This study presents a comprehensive audit conducted at Smita Memorial Hospital and Research Centre, focusing on the adherence to National Institute for Health and Care Excellence (NICE) guidelines in the Emergency Department’s (ED) acute stroke care. Undertaken from June 15, 2023, to August 15, 2023, the audit aimed to systematically assess and enhance stroke care protocols, addressing key areas for improvement and evaluating their impact on patient outcomes. Utilizing a combination of quantitative and qualitative methodologies, the audit collected pre and post-audit demographic information, employed structured surveys and checklists, and conducted interviews with healthcare professionals involved in stroke care. Statistical tools facilitated a comparative analysis between pre and post-audit data, revealing significant improvements in adherence to NICE guidelines. Findings demonstrated positive shifts in various aspects of stroke care, including increased adherence to guidelines for excluding hypoglycemia, utilization of the National Institutes of Health Stroke Scale (NIHSS), offering aspirin for suspected transient ischemic attacks (TIAs), and providing secondary prevention. Noteworthy enhancements were observed in urgent carotid imaging recommendations, admissions to acute stroke units, brain imaging practices, and supplemental oxygen provision. Despite these improvements, challenges persist in blood pressure reduction for thrombolysis candidates. The study concludes that the positive changes reflect an overall improvement in stroke care protocols at the hospital, with continuous monitoring and targeted interventions essential for sustaining these improvements and ensuring optimal stroke care.