Abstract NS2: Electronic Stroke Outcome Reporting to Enhance Practice Improvement and Education Among Emergency Nurses, A Pilot Study

Abstract

Background: Feedback is an effective mechanism to change provider behavior. However, emergency department (ED) nurses who transfer acute stroke patients, rarely receive patient outcomes. Interviews with ED nurses found that knowledge of outcomes was a source of job satisfaction, education, and potential process improvement. Purpose: The purpose of this program was to develop an electronic tool to report acute stroke patient outcomes to ED nurses. We sought to evaluate the feasibility and usability of this tool. Methods: We piloted this project in May 2018 in Nashville, TN at three EDs. Staff were identified through leadership using emails and fliers and they could specify their communication preference (email or text). Clinical presentation, operational metrics (e.g., ED arrival-to- CT), 72 hour clinical status, and interesting images (e.g., CT scan) for patients with a stroke alert were reported in a de-identified manner ( Figure ). We assessed usefulness and likelihood to change, and were able to claim continuing education credit. Simple descriptive statistics were calculated. Results: We enrolled 107 nurses and identified 56 stroke outcomes, 55 of which had at least one nurse registered. Nurses preferred email updates (79.4%) over text and viewed outcomes 41 out of 113 opportunities (36.2%). Nurses reported (N=17) a mean usefulness score (out of 100) of 81.9 (SD 15.3) and a likelihood to change (N=14) of 38.4 (SD 28.9). Four nurses either initiated or completed the continuing education activity. Conclusions: Electronic stroke outcome reporting is feasible and useful to ED nurses. Continuing education may not influence patient follow-up. The time required to summarize and create the update limits scalability but may be addressed through automatic electronic data pulls. In conclusion, an electronic tool may be an effective mechanism to communicate inter-organizational patient outcomes and may be a source of education of best practices in acute stroke care.