Table 2 Stroke services and availability in study hospitals
From: Towards best practice in acute stroke care in Ghana: a survey of hospital services
Thematic areas | Stroke services evaluated | Hospital response to available stroke services | ||
|---|---|---|---|---|
Tertiary-Teaching Hospitals (n = 4) | Regional Hospital (n = 7) | Overall Total (n = 11) % | ||
Acute Presentation of stroke | Accident and Emergency Department | 4 | 7 | 11 (100.0%) |
Local emergency department protocols for rapid triage | 1 | 0 | 1 (9.1%) | |
Common means of stroke patient transport to hospital | ||||
− Local ambulance services | 0 | 0 | 0 (0.0%) | |
− Taxi/Private transport arrangement | 4 | 7 | 11 (100.0%) | |
Diagnosis and Assessment Services | Functional CT Scan Service | 3 | 4 | 7 (63.6%) |
CT scanner (24/7) | 2 | 0 | 2 (18.2%) | |
CT scanner (weekdays 9 am–5 am) | 2 | 4 | 6 (54.5%) | |
Functional MRI Scan Service | 3 | 1 | 4 (36.4%) | |
MRI (24/7) | 0 | 0 | 0 (0.0%) | |
MRI (weekdays 9 am–5 am) | 3 | 1 | 4 (36.4%) | |
Electrocardiogram (ECG) | 4 | 5 | 9 (81.8%) | |
Electroencephalogram | 2 | 0 | 2 (18.2%) | |
Neurovascular ultrasound diagnostic services e.g. Carotid Doppler Services | 2 | 1 | 3 (27.3%) | |
Magnetic Resonance Angiography | 3 | 0 | 3 (27.3%) | |
Computed Tomographic Angiography | 4 | 4 | 8 (72.7%) | |
National Institute of Health Stroke Scale (NIHSS) | 2 | 2 | 4 (100.0%) | |
Acute Stroke services, treatments and rehabilitation services | Dedicated stroke unit (ward) | 1 | 0 | 1 (9.1%) |
General (Medical) Ward | 4 | 7 | 11 (100.0%) | |
Multidisciplinary stroke care team | 0 | 0 | 0 (0.0%) | |
Thrombolytic therapy (t-PA) | 0 | 0 | 0 (100.0%) | |
Aspirin (antiplatelet) | 4 | 7 | 11 (100.0%) | |
Early discharge care plans | 4 | 7 | 11 (100.0%) | |
Revascularization (Carotid Endarterectomy) | 0 | 0 | 0 (0.0%) | |
Decompressive surgery (craniotomy) | 0 | 0 | 0 (0.0%) | |
Arteriovenous Malformation Treatment | 0 | 0 | 0 (0.0%) | |
Surgery for Aneurysm | 0 | 0 | 0 (0.0%) | |
On site rehabilitation services | 4 | 7 | 11 (100.0%) | |
Stroke care workforce | Clinical psychologist | 4 | 4 | 8 (72.7%) |
Trained Stroke Nurses | 1 | 0 | 1 (9.1%) | |
Physician Specialist | 4 | 4 | 8 (72.7%) | |
Neurosurgeon | 3 | 0 | 3 (27.3%) | |
Medical Officer | 4 | 7 | 11 (100.0%) | |
Nurse | 4 | 7 | 11 (100.0%) | |
Neurologist | 3 | 1 | 4 (36.4%) | |
Emergency department staff | 4 | 7 | 11 (100.0%) | |
Stroke care coordinator | 0 | 0 | 0 (0.0%) | |
Occupational therapist | 0 | 0 | 0 (0.0%) | |
Physiotherapist | 4 | 7 | 11 (100.0%) | |
Speech pathologist | 0 | 0 | 0 (0.0%) | |
Social worker | 4 | 7 | 11 (100.0%) | |
Dietician | 4 | 7 | 11 (100.0%) | |
Health policy support for stroke care | Staff professional development and quality improvement for stroke care | 0 | 0 | 0 (0.0%) |
National level support/ policies for stroke care | ||||
− High | 0 | 0 | 0 (0.0%) | |
− Average | 0 | 0 | 0 (0.0%) | |
− Low | 0 | 0 | 0 (0.0%) | |
− No support | 4 | 7 | 11 (100.0%) | |
Hospital level support/policies for stroke care | ||||
− High | 0 | 0 | 0 (0.0%) | |
− Average | 0 | 2 | 2 (18.2%) | |
− Low | 2 | 1 | 3 (27.3%) | |
− No support | 2 | 4 | 6 (54.5%) | |
Stroke register/Database | 2 | 0 | 2 (18.2%) | |
Community/hospital stroke awareness program | 0 | 0 | 0 (0.0%) | |
Access to community stroke rehabilitative programs | 0 | 0 | 0 (0.0%) | |