Portrait of driving practice following a mild stroke: a secondary analysis of a chart audit

ABSTRACT

Background: The majority of individuals who have had a mild stroke are discharged home from acute care. Yet, the proportion who are assessed for driving ability and given related recommendations is unknown.

Objective: To describe acute care practice related to driving among individuals whose discharge location is home.

Methods: A secondary analysis of data from a chart audit was realized in the Province of Quebec, Canada. Data were retrieved from the charts by trained extractors. Evaluation practice was described according to whether the driving assessment was specific or nonspecific to driving (cognitive, perceptual and visual functions). Descriptive statistics were used.

Results: The sample consisted of 419 charts of individuals with a mean age of 70.5 ± 13.3 years old. Mean length of hospital stay was 10.3 ± 13.3 days. Specific driving assessment was documented among 26/419 (6.2%) charts while for seven of these, the assessment was considered full. Meanwhile, 92/419 (22.0%) were considered as problematic for driving a vehicle. Nonspecific driving assessment was documented among 70/419 (16.7%), 43/419 (10.3%) and 33/419 (7.9%) of charts for cognitive, perceptual and visual functions, respectively. Charts were characterized by several missing data relating to driving.

Conclusion: The proportion of charts documenting driving restriction post-stroke in acute care was very low. Assuming that all driving discussions and referrals were captured in the charts (which may not be the case), our results would indicate an important gap in acute care practice as compared to best practices relating to driving post-stroke.

KEYWORDS:

• Mild stroke
• driving
• acute care
• chart audits

Ethics approval

Obtained for the original larger study entitled Partnerships for Health System Improvement (PHSI) - Towards a Continuum of Services for Stroke: Evaluation of Rehabilitation Services Structures, Processes and Performance Indicators

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research for the original larger study; Institute of Health Services and Policy Research.