Development of a National Stroke Audit to Enhance Acute Stroke Care Quality in Ireland:Scoping Review & Delphi Consensus

Abstract

Background Population ageing, treatment advances, evolving models of care, and between-hospital heterogeneity in patient outcomes underscore the need for continual audit to ensure the delivery of high-quality, equitable, and evidence-based stroke care. This study aimed to develop a core minimum dataset for acute stroke care in Ireland, for integration into the Irish National Audit of Stroke (INAS), benchmarked against, and aligned with, international best practice. Methods This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Medline Ovid, Embase, CINAHL EBSCOhost, and pertinent grey literature were searched from 2010 to identify national and continuous stroke audits. Titles, abstracts, and full texts were assessed for eligibility. Audit documentation was retrieved from identified eligible audits and stroke care data items were extracted, translated, and charted. Data charting enabled comparison of existing Irish audit items with frequently collected international items to identify commonalities and/or gaps in coverage. Acute stroke care items were then reviewed by key stakeholders in a three-round Delphi consultation. Results Twenty-one eligible international stroke audits and registries were identified, containing ~4,500 audit items. Key stakeholders were consulted for their expert perspectives on the existing Irish (n=103), frequently collected international (n=97), and additional expert-suggested (n=22) acute items regarding their potential inclusion in INAS. Following consensus, a core minimum dataset comprising 86 acute care and 35 thrombectomy items was finalised. Conclusions The findings of this scoping review represent the ?ideal? core outcomes dataset for acute stroke care in Ireland, derived from international benchmarking and stakeholder consultation. This dataset serves as the ?gold standard? for monitoring acute stroke care in Ireland, aimed at enhancing patient outcomes, and supporting local and national quality improvement initiatives.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Health Research Board Ireland [APA-2019-036]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

The data that support the findings of this study are available from the corresponding author, [CNM], upon reasonable request.

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