The National Institutes of Health Stroke Scale (NIHSS) is accepted as the definitive clinical examination to assess stroke severity. This project examined barriers to implementation and NIHSS use by registered nurses on a stroke/neurovascular Unit. Staff members were surveyed to determine nurse-perceived barriers to the routine use of the NIHSS. Survey results were used to create interventions including staff education, emphasis on NIHSS assessment during interdisciplinary rounds, and use of pocket cards. When the survey was redistributed 9 months later to verify results of the quality improvement initiative and guide further interventions, NIHSS assessment had increased from 12% to 69%. NIHSS scores have been linked to an existing outcomes database to monitor acute stroke treatment and inpatient management outcomes.
Questions or comments about this article may be directed to Jenny Richardson, MS RN, at firstname.lastname@example.org. At the time the study was completed, she was a clinical nurse specialist at Providence Stroke Center, Providence St. Vincent Medical Center, Portland, OR. She is now a clinical nurse specialist in the intensive care unit of Portland VA Medical Center, Portland, OR.
Diana Murray, MS RN, is a stroke and neurovascular staff nurse at Providence St. Vincent Medical Center.
C. Ken House, MS, was the director of neuromusculoskeletal research for Providence Stroke Center Health System, Providence St. Vincent Medical Center, at the time the study was completed. He now works in outcomes and performance measurement at St. Charles Medical Center, Bend, OR.
Ted Lowenkopf, MD, is the medical director of the Providence Stroke Center at Providence St. Vincent Medical Center.
© 2006 American Association of Neuroscience Nurses