Abstract TMP85: Enhancing Stroke Nursing Education Through Simulation
BACKGROUND: During a Primary Stroke Center recertification survey by The Joint Commission at this 504 bed community hospital a knowledge gap was discovered in applying the National Institutes of Health Stroke Scale (NIHSS) at the bedside and correlating it with clinical findings. Since 2009, this stroke program has required nurses caring for acute stroke patients to complete NIHSS certification annually. The purpose of this simulated educational competency program was to verify performance of the NIHSS and provide education correlating symptoms with brain physiology.
METHODS: Nurses caring for acute stroke patients attended this mandatory educational program which included a review of anatomy, NIHSS application and scoring on a simulated patient, and a debriefing discussion. The simulated patients were assigned specific deficits to portray. Immediate feedback was provided to participants upon completion. Symptoms of each patient were correlated with the affected brain physiology during a group debriefing discussion. Participants evaluated their perceived competency performing the NIHSS and associating brain physiology before and after the session using a four point Likert-type scale with 1 being strongly disagree and 4 being strongly agree.
RESULTS: Competency was demonstrated by 196 nurses with 174 completing evaluations expressing high satisfaction with the material and mode of learning. Evaluation data was analyzed using descriptive statistics and a paired t test showing improvements in self perceived NIHSS competency and ability to correlate the affected brain physiology. The mean self perceived NIHSS competency prior to the session was 3.28 compared to 3.90 post session (t(172) = 13.99, p < 0.01). The mean self perceived ability to correlate the affected brain physiology prior to the session was 2.61 compared to 3.57 post session (t(173) = 18.09, p < 0.01).
CONCLUSION: The current NIHSS certification examination has known limitations. Integrating simulated learning experiences together with NIHSS certification resulted in perceived improvement in understanding and competency. Follow up is necessary to determine if this translates into improved bedside clinical practice.
- © 2012 by American Heart Association, Inc.