What are the components of effective stroke unit care?

Background: The effectiveness of organized inpatient (stroke unit) care has been demonstrated in systematic reviews of clinical trials. However, the key components of stroke unit care are poorly understood. Methods: We conducted a survey of recent trials (published 1985-2000) of a stroke unit/ward which had demonstrated a beneficial effect consistent with the stroke unit systematic review. Results: We identified 11 eligible stroke unit trials of which the majority described similar approaches to i) assessment procedures (medical, nursing and therapy assessments), ii) early management policies (e.g. early mobilization; avoidance of urinary catheterization; treatment of hypoxia, hyperglycaemia and suspected infection), iii) ongoing rehabilitation policies (e.g. co-ordinated multidisciplinary team care, early assessment for discharge). Conclusions: This survey provides a description of stroke unit care which can serve as a benchmark for general stroke patient care and future clinical research.