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QUALITY ASSISTANCE INDICATORS OF A LEVEL III STROKE UNIT OF A DEVELOPING COUNTRY

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ESOC-2019

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Abstract

Background & Aim: Stroke is one of the leading causes of death in the world and hospital care quality can impact the patient's prognosis. The aim is to evaluate the quality indicators according to Resolution No.665 for implementation in stroke treatment published by the Brazilian Ministry of Health in 2012, in a level III Brazilian Stroke Unit. Methods: Prospective study in which 13 quality indicators were analyzed from January to December/2018. Of the indicators, were highlighted: door-to-CT scan time; door-to-needle time; length of stay; percentage of patients admitted with cerebrovascular disease; deep vein thrombosis (DVT) prophylaxis; use of antiplatelet agents until 48 hours; pneumonia rate and hospital mortality. The unit has capacity for 10 beds monitored, neurology/neurosurgery and thrombolysis 24h per day, 7 days a week, and full multiprofessional team. It is referenced and focuses on stroke acute phase, etiological investigation, complication prevention and rehabilitation with a maximum 15 days length of stay. Results: A total of 275 patients with median age of 69 (59-78) years were included, 56.4% male, 19.4% were thrombolysed, 78.5% admitted with acute cerebrovascular disease, 87.2% with door-to-CT scan time <25 minutes, 57.1% with door-to-needle time <60 minutes, length of stay of 6 (4 - 9) days, 92% of the patients received DVT prophylaxis, 95% had antiplatelet use until 48h of hospitalization, a pneumonia rate of 6.9% and hospital mortality of 4%. Conclusion: The results allowed to evaluate the parameters required by Brazilian Ministry of Health, enabling the weaknesses knowledge, facilitating the management work and allowing the service improvement.

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