Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Emergency Department Nurses' Perceived Barriers and Facilitators to Caring for Stroke Patients

Johnson, Melissa; Cohn, Jennifer; Bakas, Tamilyn

Journal of Neuroscience Nursing: October 2011 - Volume 43 - Issue 5 - p 238-243
doi: 10.1097/JNN.0b013e318228e1cb

Stroke is currently the 3rd leading cause of death in the United States and is the leading cause of severe, long-term disability. With the advent of recombinant tissue plasminogen activator/alteplase, there is a treatment option for ischemic stroke. Unfortunately, only a small number of eligible patients receive this treatment. Whereas much research has been performed on barriers to treatment related to prehospital delays, less research has been performed on in-hospital delays related to hospital staff's perceptions of stroke patients. In this qualitative exploratory study, focus group interviews were conducted to examine emergency nurses' experiences in caring for stroke patients. A convenience sample was recruited using flyers distributed in the emergency department. Three groups of emergency nurses were interviewed in a private location within the facility. The 30-minute, semistructured interviews included 2 to 4 emergency nurses and were moderated by the investigator. Individual transcripts were analyzed for trends, patterns, and recurring themes. Three major themes regarding barriers to and facilitators of stroke care emerged: (a) nurses' comfort with assessment of stroke patients, (b) feedback regarding nurse performance and patient outcomes; and (c) environmental issues such as staffing, competing priorities, and patient and family needs. Despite the various challenges facing emergency nurses, all groups verbalized a desire to provide excellent care to these patients. Further research is recommended to address these challenges and to explore potential solutions identified in this study to improve the care of stroke patients.

Questions or comments about this article may be directed to Melissa Johnson, MSN RN CNS CNRN, at She is a critical care clinical nurse specialist at Scripps Mercy Hospital, Chula Vista, CA.

Jennifer Cohn, MSN RN CNRN, is a clinical director at the St. Vincent Neuroscience Institute in Indianapolis, IN.

Tamilyn Bakas, PhD RN FAHA FAAN, is a professor at the Indiana University School of Nursing, Indianapolis, IN.

Funding for this study was provided by Indiana University School of Nursing Graduate Student Funds.

© 2011 American Association of Neuroscience Nurses