Exploring secondary prevention after stroke: a survey of Irish stroke clinical nurse specialists and advanced nurse practitioners

BACKGROUND: ESD enables stroke patients to leave hospital earlier and continue receiving nursing and therapy at home over a 6-8-week period. The CNS role within ESD is relatively new, and its involvement in stroke secondary prevention is not well defined. AIMS & OBJECTIVES: To describe the current role, knowledge, and practice of Stroke Clinical Nurse Specialists (CNSs) and Advanced Nurse Practitioners (ANPs) in secondary prevention and their contribution to early supported discharge (ESD) for stroke patients. DESIGN: Cross-sectional survey. METHODS: An online survey was distributed to Stroke CNSs and ANPs working in inpatient stroke services or ESD teams. It explored three domains: (i) secondary prevention at initial hospital contact, (ii) secondary prevention at discharge, (iii) secondary prevention during ESD. RESULTS: The respondents described the pivotal role of stroke clinical nurse specialists (CNSs) and advanced nurse practitioners (ANPs) in delivering secondary prevention from hospital admission through to discharge. Persistent challenges in patient information retention during acute care were highlighted. Participants identified structured national resources-particularly printed materials over apps-as essential tools for effective secondary prevention. CONCLUSION: Despite broad recognition of their value, integration of stroke CNSs into Early Supported Discharge (ESD) teams remains inconsistent, signalling a key area for service development in Ireland. There is a clear need to enhance continuity of nurse-led secondary prevention in community settings, particularly within ESD pathways.