Abstract T P272: Improving Staff Nurse Confidence in Responding to Inpatient Stroke

Abstract

Background and Issues: Studies reveal greater in-hospital delays on evaluation for stroke when they occur in the hospitalized patient. Only 15 percent of in-hospital strokes are evaluated by a physician within 3 hours of onset. This significantly surpasses the Golden Hour target of 60 minutes to treat eligible patients. The more time that passes in eligible patients, the greater the extent of brain ischemia to be expected. Well-planned and executed stroke response processes must be developed within hospitals so that teams treating hospitalized stroke patients can achieve the time sensitive goal of door to needle within 60 minutes. Purpose: The purpose of this study was to optimize the response of inpatient staff nurses and promote their confidence with executing a newly developed inpatient stroke response process. Sample: Fifty-seven staff RNs in two medical-surgical units of a community hospital Method: The method included educational inservices with pre and post survey data collection. Each survey assessed RN knowledge of responding to inpatients having acute stroke symptoms and their confidence level in implementing the appropriate response. Simulation drills were conducted a month later. The drills assessed the RNs’ response to a stroke scenario and provided opportunities to role play each step of the interdisciplinary process. A post-drill survey assessed the RNs’ confidence with implementing the inpatient stroke response process. Results: Measureable increase in self-reported RN confidence with both recognizing and responding to acute stroke in hospitalized patients. On a 4 point likert-type scale, mean overall confidence in recognizing stroke symptoms went from 2.91 to 3.3 among all experience levels. Mean overall confidence in responding to stroke increased from 2.77 to 3.26. Data was stratified to reflect years of RN experience. Conclusions: RNs who participated in focused education and stroke process drills reported increased confidence in their role in stroke recognition and response. Additional data is needed to determine if increased RN confidence will lead to earlier detection of stroke, earlier interventions, and better outcomes.