Abstract T P254: Bedside Video Transfer Report: National Institutes of Health Stroke Scale (NIHSS)

Abstract

Background: Transition of the stroke patient from acute care to rehabilitation requires detail focus to ensure high quality consistency of care. Standard transfer report includes phone report; excluding the patient and visual representation of NIHSS. Dual neurological exam is the standard of practice between every registered nurse (RN) hand-off of the stroke protocol patient in our acute care institution. The current challenge is bridging this practice gap between acute care and rehabilitation phases. Additional clinical challenges include readmission rates, patient expectations, NIHSS expertise sharing, and communication. Purpose: The purpose is to increase coordination of care of the acute stroke protocol population, between the acute care and rehabilitation RNs. The goal of a live stream bedside video report is to provide real-time visual assessment of a patient’s neurological status prior to transfer. Visual representation of neurological function allows providers to rapidly identify a change in patient status. The ultimate goal is to narrow the acute care discharge to post-acute admission NIHSS range as well as decrease readmission rates. Methods: The acute care RN notifies the rehabilitation RN a patient is prepared for transfer. The RNs establish a video connection at the bedside, introduce the receiving RN, explain what to expect through transition, provide a brief SBAR report, followed by the completion of the NIHSS. Upon arrival to the rehabilitation hospital the receiving RN completes the admission NIHSS as an initial component of assessment. The RN will be able to confirm the stability of the patient’s neurological function, establishing an accurate stable baseline admission status. Results: The video report was successful in establishing a well communicated/visualized neurological status, and narrowing the gap between NIHSS. The patient’s apprehension towards transfer was minimized; questions were addressed prior to transfer. Conclusions: In conclusion, video report with visualization of neurological status and NIHSS exam allows care providers to receive a patient, confidently assess and verify stability of neurological function; increasing the ability to make informed care decisions impacting the stroke patient.