The Canadian Best Practice Recommendations for Stroke Care (Update 2010) presents high-quality, evidence-based stroke care recommendations in a standardized framework to support healthcare professionals in all disciplines. Implementation of these recommendations is expected to contribute to reducing practice variations and closing the gaps between evidence and practice.
Scope: This document provides a synthesis of best practices in stroke care across the continuum from stroke symptom onset to community reintegration and long-term adaptation, and includes stroke care for acute ischemic stroke, transient ischemic attack, subarachnoid hemorrhage, and intracerebral hemorrhage. The recommendations reflect areas of stroke care with the highest levels of available research evidence (Class I, Level A), and those areas that are considered key system drivers of stroke care in Canada (Class I and Class II, Levels A to C). They cover stroke management, management of risk factors such as hypertension and dyslipidemia, and co-morbid conditions such as carotid stenosis, diabetes, and atrial fibrillation.
In this document, the “continuum of stroke care” is defined as including:
- primary prevention, health promotion, and public awareness
- hyperacute stroke management
- acute stroke management
- stroke rehabilitation
- prevention of stroke recurrence (secondary prevention)
- community reintegration
- long-term recovery and adaptation
Target audiences: The recommendations are targeted to health professionals throughout the health system who care for those affected by stroke. Health system policy makers, planners, funders, senior managers, and administrators who are responsible for the coordination and delivery of stroke services within a province or region will also find this document relevant and useful to their work.
The primary focus is front-line healthcare professionals from a range of disciplines, including primary care practitioners, neurologists, internists, emergentologists, nurses, physiatrists, physical therapists, occupational therapists, speech-language pathologists, social workers, dieticians, pharmacists, psychologists, and other disciplines and support staff who provide direct care to stroke patients.
The CSS recognizes that human, financial, and system resource limitations make it difficult to implement everything in this document. However, the recommendations and performance measures are presented as “gold standard” benchmarks toward which all organizations and systems should strive. Additionally, they can be valuable tools and information sources for anyone advocating for improved stroke care services.