Abstract TMP86: Evaluation of NIHSS Application Program to Stroke Nurses
Background and purpose: Neurologic assessment for stroke nurse is very important, since exact examination and finding for neurologic symptoms greatly affect prognosis of stroke. NIHSS is a tool to best reflect neurologic status for acute ischemic stroke and this is mostly measured by neurologists. Although the closest medical team member is a nurse, indeed there are not many hospitals where a nurse measures NIHSS and related researches are also insufficient. The purpose of this study is to evaluate quality of nursing as NIHSS Application Program (NAP) to stroke nurses.
Methods: NAP was performed from April to July, 2010 as following. Theoretical and practical educations for NIHSS by a stroke clinical nurse specialist were performed for stroke nurses and they completed learning for video lectures and certification individually by website. NIHSS was measured every shift and integrated with electrical medical records. This research compared medical records before and after NAP and set participants who were hospitalized in acute stroke unit through emergency room and diagnosed ‘ischemic stroke’. Pretest group (n=100) was set from January to March, 2009 and posttest group (n=115) was set from January to March, 2011. Pearson’s t-test and chi-square test were used to measure differences between two groups.
Results: Nursing records for neurologic assessment items were all increased (50% versus 95%, p=.008). Especially items for ‘neglect, dysarthria, visual disturbance, pupil status, and EKG’ were significantly increased. Number of notified cases for neurologic changes by nurse was increased (21% versus 39%, p=.004). Most of notified reasons were focused on ‘limb motor function’ in pretest group while items for ‘alertness/awareness, facial palsy, limb ataxia’ were newly reported for posttest group. Among notified cases, patients detected extensions of stroke lesions (6% versus 10%, p=.000) and patients treated induced hypertension therapy were both increased (13% versus 22%, p=.000).
Conclusions: NAP improved nurses’ degree of knowledge for stroke patients and this contributed to prevention of deterioration of stroke. It is widely needed to apply NIHSS by stroke nurses for quality of nursing.
- © 2012 by American Heart Association, Inc.