Abstract
Background: Patients receiving care from stroke specialized nurses have better outcomes. In 2021, the American Heart Association/American Stroke Association (AHA/ASA) published updates to the Comprehensive Nursing Care Scientific Statements providing new evidence and best nursing practices in stroke care. Nursing leadership at a Comprehensive Stroke Center identified this as an opportunity to utilize the Nursing Care Scientific Statements and other AHA/ASA stroke clinical practice guidelines (CPG) to optimize stroke program education and improve quality of nursing care. Purpose: The purpose of this study was to determine whether an escape room activity significantly increases knowledge of stroke CPGs and best nursing care practices and to assess nurses’ confidence in their application when compared to viewing online modules alone. Methods: Based on a literature review and learning needs assessment, nine escape room puzzles were developed spanning the continuum of stroke care. Each puzzle required the application of a CPG or scientific statement to a patient scenario. A variety of materials were used to develop the puzzles, including black lights, locks, jigsaw puzzles, and a custom learning environment in EPIC. Participants submitted a pre- and post-survey to capture qualitative and quantitative data regarding the nurse’s knowledge of and confidence in applying stroke CPGs and best practices. A paired two-sided T-test was conducted using a confidence interval of 95% and sample size of 75 to determine whether the post-survey increase in nurse knowledge and confidence was significant. Results: For all five Likert items, the p-value was less than 0.05, indicating a statistically significant improvement in nurses’ knowledge of and confidence in applying stroke CPGs and best practices. The qualitative data demonstrated a learner preference for the interactive nature of the escape room and the teamwork and critical thinking that it fostered. Conclusion: In conclusion, there was a statistically significant increase in nurse confidence and knowledge of comprehensive nursing stroke care and stroke CPGs after the escape room intervention. This suggests that escape room activities can be an effective way to develop clinical knowledge in stroke nursing.
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