Abstract P161: The Effect of Simulation Based Education on Nursing and EMS Stroke Care

Abstract

Background: Treatment options for acute ischemic stroke (AIS) now include mechanical thrombectomy. As a result, primary stroke centers (PSC) must quickly identify large vessel occlusion (LVO) patients, treat them with alteplase when appropriate and transfer them to a comprehensive stroke center (CSC) for potential mechanical thrombectomy. Given the need for expedited care in the emergency department, collaboration with emergency medical services (EMS) in the pre-hospital setting and timely administration of alteplase prior to transfer to the CSC have been identified as practice gaps. Purpose: To examine the effect of an educational stroke simulation session on the knowledge and confidence level of registered nurses (RN) and EMS providers who care for patients with acute stroke receiving alteplase. Methods: Simulations were 60 min, in groups of 4-5 RNs and 1-2 EMS providers, and focused on neurological assessment, administration of alteplase, and rapid transfer when a LVO is suspected and/or identified. Participants completed a pre and post simulation survey assessing confidence levels of nurse role actions and knowledge of stroke care (Table 1). A paired samples t-test examined differences in confidence levels and total percent of correctly answered questions on the survey, pre versus post simulation. A McNemar test examined differences in the proportion of participants that correctly answered each question on the test pre versus post simulation. Results: Following the stroke simulation, the confidence levels of nurses increased for all nurse role actions (all P s<0.01; Table 1) and there was an increase in the number of correct answers for 3 of the 6 test questions (all P s<0.05; Table 1), as well as the total percent of correctly answered test questions ( P <0.001). Conclusions: Simulation based education can be an effective training tool for improving the knowledge and confidence of nursing and EMS providers in the management of AIS.