One in ten people suspected of suffering a stroke are not brought to a hospital providing specialist treatment within the recommended four hours of the onset of symptoms.
A HSE audit found that 8% of patients were not transported by ambulance to hospitals providing acute stroke care within the timeframe that is meant to increase chances of a full recovery.
Poor record-keeping meant the HSE could not determine if the four-hour target was met in another 28% of cases.
Ambulance crews are meant to notify hospitals about incoming patients with suspected stroke but pre-alert times were only recorded in 13% of cases.
The HSE said the findings mean it could not provide reasonable assurance that the National Ambulance Service was compliant with its own procedures.
The audit of a sample of cases of suspected stroke recorded in the second half of 2016 found almost two-thirds of patients were brought to a hospital providing specialist care within four hours.
The number of cases meeting the four-hour timeframe ranged from 58% in north Leinster to 63% in the South and 73% in the West.
The study was carried out to access levels of compliance with procedures adopted by the National Ambulance Service on appropriate hospital access for suspected stroke patients.
Under protocols, ambulance crews should use the internationally recognised FAST test on arrival at the scene to assess if the patient has suffered a stroke and then record the information on a patient care report.
The test is based on whether patients show signs of facial dropping, arm weakness and speech difficulties.
The audit of patient care reports found no evidence that the FAST test was conducted in 25% of cases.
It showed some ambulance crews recorded the time of the onset as when the patient had developed symptoms of a stroke, while others recorded the time as when they assessed the patient.
The audit said there was a lack of clarity about what time should be recorded on the patient’s record.
It said senior officials in the National Ambulance Service must establish why there was a lack of compliance in documenting key times on patient records.
“Measures must be put in place to ensure times are recorded as per the NAS procedure,” states the audit.
There are 24 hospitals in the Republic which provide acute care for stroke patients.
According to the Irish Heart Foundation, there are around 30,000 people living with a stroke-related disability.
On average, around 10,000 people suffer a stroke each year, of which almost 2,000 die.
Stroke is generally defined as an interruption of the blood supply to any part of the brain.
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