Clinical guideline adherence by physiotherapists working in acute stroke care

Area of Science:

• Clinical physiotherapy
• Stroke rehabilitation guidelines
• Healthcare quality improvement

Background:

• The 2009 Irish Clinical Guidelines for Stroke aimed to enhance stroke care.
• Adherence to these guidelines is crucial for effective stroke service delivery.
• Understanding current practice is essential for targeted improvements.

Purpose of the Study:

• To assess the adherence of Senior Physiotherapists in acute stroke care to the Irish Clinical Guidelines for Stroke.
• To identify areas of high and low compliance with specific guideline recommendations.
• To explore barriers affecting guideline implementation.

Main Methods:

• A cross-sectional survey study was conducted.
• Surveys were distributed to 31 Senior Physiotherapists in acute stroke care.
• A 74% response rate (23 participants) was achieved via postal or online distribution.

Main Results:

• Excellent compliance (82.6%) was observed for timely full assessment and documentation within 5 working days.
• High compliance (82.6%) was noted for patient involvement in goal setting.
• Poor compliance was reported for early assessment (43.5%) and adequate rehabilitation intensity (39%).

Conclusions:

• While some aspects of stroke care align well with guidelines, significant gaps exist.
• Organizational factors are the primary barriers to implementing early assessment and intensive rehabilitation.
• Further research and interventions addressing organizational barriers are needed to optimize stroke care.