Abstract T P270: Effectiveness of National Institute of Health Stroke Scale Training
Background and Purpose: Staff voiced a need for hands on training regarding scoring of complex stroke patients. Random reviews of medical record documentation of the National Institute of Health Stroke Scale (NIHSS) scoring and discussions with staff reflected variations in scoring for the same deficits. The primary training method utilized by all staff has been computer based with preceptor skill verification. Continued issues with confusion in scoring led to development of a unique solution for our facility and community partners using this scale.
Method: Members of our nursing and medical team developed a unique learning opportunity that provided participants with both didactic and hands on participation for scoring of patients with the NIHSS. Lectures consisted of overview of stroke syndromes including complex syndromes, basic NIHSS knowledge and scoring requirements, followed by review of complex scoring strategies and a live classroom scoring presentation by a provider on a test patient. The learning opportunity was further enhanced by interactive sessions for hands on by each participant through scoring every component of the scale in a non-threatening environment. This was accomplished through the use of smart phones and computers which blinded individual responses. Standardized test patients trained by the instructors executed scenario responses ranging from normal to extremely abnormal and/or complex. Participants scored scenarios executed using the NIHSS and received immediate feedback on scoring rationales. Questions and inaccuracies were addressed and clarified in each session.
Results: The initial class evaluations and changes in pre and post class scoring results indicate less variation in scoring for all items, especially related to scoring of the complex patient.
Conclusion: Computer based learning is the most common and widely used approach to staff education for training staff on use of the NIHSS. However, face to face interaction with the learner and instructor appears to be the most effective method for skill attainment with scoring of complex stroke patients.
Author Disclosures: A. Jones: None. G. Campbell: None.
- © 2014 by American Heart Association, Inc.