This measure is used to assess the percentage of inpatients with a diagnosis of ischaemic stroke receiving aspirin within 48 hours of presentation to hospital.

It is well documented that anti-platelet agents have a vital role in the secondary prevention of any future ischaemic stroke. Evidence from large robust studies confirm that early use of aspirin, within 48 hours of stroke, has small but important benefits on patient outcomes.

Acute ischaemic stroke; hyperacute pharmacological therapy; aspirin

Total number of inpatients separated from hospital with a diagnosis of ischaemic stroke, without contraindication for aspirin (see the related "Denominator Inclusions/Exclusions" field)

Total number of inpatients with a diagnosis of ischaemic stroke receiving aspirin within 48 hours of presentation to hospital (see the related "Numerator Inclusions/Exclusions" field)

Unspecified

Unspecified

Unspecified

6 months

Inclusions
Total number of inpatients separated* from hospital with a diagnosis of ischaemic stroke**, without contraindication for aspirin

*Separation refers to discharge, transfer or death.

**Note:

• Stroke is defined as cerebral infarction or haemorrhage.
• This indicator relates to acute strokes only. Refer to the original measure documentation for relevant International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM) codes.

Exclusions
Unspecified

Inclusions
Total number of inpatients with a diagnosis of ischaemic stroke* receiving aspirin within 48 hours** of presentation to hospital

Note: Compliance requires:

• Date and time of presentation to hospital
• Date and time aspirin administered
• Dose of aspirin administered
• Contraindications clearly documented

*Refer to the original measure documentation for relevant International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM) codes.

**Within 48 hours is the time aspirin (150-300mg) is prescribed and recorded as administered on the patient's medication chart compared to the documented time of presentation to hospital. If aspirin is contraindicated or not prescribed, however, the clinical reason/s are documented in the patients notes (e.g., patients with cerebral haemorrhage or with adverse drug reaction or those already taking warfarin).

Exclusions
Unspecified

General Medical Indicators Discharge Checklist

Indicator area 3: acute stroke management CI 3.4.

Funding is direct Australian Council on Healthcare Standards (ACHS) funding sourced through our membership. ACHS does not receive external funding from the government or other sources.

Our terms of reference dictate the composition of the working parties that develop our indicators and include the following:

• Two Clinicians -- nominated by the relevant specialty college/association/society, one nominated to be the chair of the working party
• Private Hospital Representative -- nominated by the Australian Private Hospital Association
• Consumer Representative -- nominated by the Consumer Health Forum of Australia
• Coding Representative -- nominated by the National Centre for Clinical Classification on Health
• Quality Health New Zealand, nominated by QHNZ (if applicable)
• Epidemiological/Clinical Research Representative, Director of Health Services Research Group, University of Newcastle
• Australian Council on Healthcare Standards (ACHS) Representatives -- Clinical Director, Coordinator, Administrative Assistant
• Other Expert Stakeholders, as required

None

This indicator has been adapted from the 14 Acute Stroke Management Indicators developed by the National Stroke Foundation in 2008.

Unspecified

Unspecified

Please note: This measure has been updated. The National Quality Measures Clearinghouse is working to update this summary.

The individual measure, "Indicator Area 3: Acute Stroke Management CI 3.4," is published in "ACHS Clinical Indicator Users' Manual 2011."

For more information contact, the Australian Council on Healthcare Standards (ACHS), 5 Macarthur Street, ULTIMO NSW 2007; Phone: (02) 9281 9955; Fax: (02) 9211 9633; E-mail: pos@achs.org.au; Web site: www.achs.org.au .

This NQMC summary was completed by ECRI Institute on April 10, 2012.

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions. This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without written permission from The Australian Council on Healthcare Standards (ACHS).