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Can Children Reduce Delayed Hospital Arrival for Ischemic Stroke?

A Systematic Review of School-Based Stroke Education

Beal, Claudia C.; Flanders, Sonya A.; Bader, Susan Gerding

Journal of Neuroscience Nursing: June 2016 - Volume 48 - Issue 3 - p E2–E13
doi: 10.1097/JNN.0000000000000202

ABSTRACT Background: Delayed hospital arrival after onset of ischemic stroke reduces the number of patients eligible for tissue plasminogen activator, which must be given soon after stroke onset. There are conflicting results about the impact of mass media stroke education on timing of hospital arrival and tissue plasminogen activator administration rates. School-based programs are a new way to communicate stroke information. Methods: A search of MEDLINE, CINAHL, PsycINFO, and ERIC databases from 1995 to 2014 identified school-based stroke education interventions. Twelve studies involving 3,312 children and 612 parents met criteria for review. Results: School-based stroke education interventions were effective to improve knowledge of stroke symptoms among children in kindergarten through junior high. Improvement for stroke risk factors was less robust. Interventions were effective regardless of format, length, or who delivered the information. Despite low parental response rates in some studies, there was evidence that children transmitted stroke information to parents. Conclusions: School-based stroke education programs appear effective to improve knowledge of stroke symptoms. Research is needed to determine if children who participate are able to recognize stroke and respond appropriately by calling 911 in the real world. More study is needed about transfer of stroke knowledge from child to parent. Strategies to improve parent participation are needed.

Questions or comments about this article may be directed to Claudia C. Beal, PhD RN at She is an Assistant Professor, Baylor University Louise Herrington School of Nursing, Dallas, TX.

Sonya A. Flanders, MSN RN ACNS-BC CCRN, Clinical Nurse Specialist, Adult Nursing, Center for Learning Innovation and Practice, Baylor Scott & White Health-North Division, Dallas, TX.

Susan Gerding Bader, MLS AHIP, Director, Learning Resource Center, Baylor University Louise Herrington School of Nursing, Dallas, TX.

The authors declare no conflicts of interest.

© 2016 American Association of Neuroscience Nurses