Abstract W P264: Perception of Educational Benefits of Online National Institute of Health Stroke Scale Training by Nursing Staffs

Abstract

Background: Primary Stroke Center at University Medical Center (UMC) in Lubbock, Texas requires nursing staffs who are directly caring for stroke patients to obtain NIHSS training by certification via an online training program by NINDS and/or AHA. One of quality improvement programs by UMC is to evaluate the compliance and reliability of neurologic assessment of stroke patients by nursing staff. Purposes: The purpose of this study is to evaluate the current perception and effectiveness of online training for quality improvement. Methods: We performed survey on licensed staff members in the Emergency Department (ED), Medical Intensive Care Units (MICUS) and one Medical Surgical Unit (MSU) to determine perception on the effectiveness of the current online education (OE) and on the inter-rater reliability between staffs and units. Results: 164 nurses completed the survey: 81 from ED, 63 from MICU, and 20 from MSU. 55% of staff rated the OE as excellent, 33% as good, and 12% as poor. 42% believed inter-rater reliability was excellent, 32% as good and 19% rated the intra-rater reliability as poor. Regarding how comfortable they were with performing the NIHSS exam, 11% rated themselves as poor, 29% as good, and 65% as excellent. The staffs performed three NIHSS exam (range 0– 40) on average after their training. Extinction and inattention, limb ataxia, dysarthria, and language were felt most difficult to assess, which was similar to previous studies. The majority of group which rated inter-rater reliability as poor worked at the ED and MICU. Some of the suggestions include hands-on training with standardized patient, hands-on training of intubated patients with simulation, regular onsite and online education, and enjoyable education materials. Conclusions: In conclusion, NIHSS online training is an effective way to train nursing staffs but additional and regular educations are needed after the initial online training. Based on the evaluation data, Stroke Program at UMC is developing NIHSS training program utilizing standardized patients in simulation and will implement in education for quality improvement in clinical practice and inter-rater reliability.