Stroke is now the third leading cause of disability and the second leading cause of mortality worldwide. Stroke is expected to increase by 1-2% annually. NZ needs to ensure Stroke patients receive the best care from the NZ health services. NZ stroke funding from the MOH supports best practice stroke care which is well evidenced internationally. The MOH has targets indicators for patients who are admitted for stroke care.These include that 80% of all patients admitted with a for stroke, are cared for in an acute stroke unit, that 12% of those patients receive thrombolysis, and those patients are referred to rehabilitation within 7 days of admission preferable in 3 days.
The National Stroke Network provides national clinical leadership to MOH and DHBs to achieve the provision of high quality sustainable and comprehensive stroke services from primary prevention through to post stroke community services. NZ stroke care is evolving in line with evidenced based practice and the online Clinical guidelines to stroke management 2017. These guidelines are a living document and form the basis for best practice in NZ.
The value of stroke units have been extensively investigated in clinical trials and meta-analyses. The benefits of dedicated stroke units can reduce death, disability, dependency, disability, residential long term care, increase patient satisfaction, quality of life. More cost effective at achieving best outcomes.
In its simplest and most basic form, it is a dedicated stroke unit or group of stroke beds in a hospital where acute stroke patients are cared for by dedicated intradisciplinary stroke trained clinical staff. The staff are led by a dedicated lead stroke physician, stroke nurse and an allied staff member.