Introduction Hypercholesterolaemia and diabetes are established modifiable risk factors for cerebrovascular disease. A baseline audit carried out on an acute stroke ward in Kent showed variability in blood tests being requested on admission for suspected stroke patients, in particular glucose and lipid profile.

Aim To ensure that atleast 80% of patients admitted to the stroke ward with suspected stroke have blood glucose and cholesterol levels measured on admission over an 18-week period.

Methods The percentage of patients with suspected stroke on the ward who had blood glucose and/or total cholesterol levels requested on admission was measured weekly. 3 interventions were introduced in the form of Plan Do Study Act cycles: educational email to doctors regarding the assessment of stroke patients and mandatory admission blood tests, adaptation of the ‘Stroke Admission Clerking Proforma’ to include a reminder of bloods to be requested and production of an all-inclusive ‘Stroke bloods panel’ on the online system for requesting bloods.

Results At baseline, an average of 30% and 34% of patients had glucose and cholesterol levels requested on admission, respectively, which increased to 43% and 40% respectively, after the email. This increased to 71% and 61% after the introduction of the proforma, and after the final intervention, on average, 82% and 85% of patients had glucose and cholesterol levels requested on admission, respectively. The results showed non-random variation.

Conclusions We achieved our aim of ensuring that more than 80% of patients with acute stroke had both glucose and cholesterol levels requested on admission. The stroke proforma and the bloods panel were the most effective interventions. The changes were implemented in another hospital within the same Trust. We anticipate greater compliance with NICE and Trust guidelines regarding appropriate and timely prescription of antidiabetic and cholesterol-lowering medications for secondary prevention.