Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Implementation of a Stroke Competency Program to Improve Nurses’ Knowledge of and Adherence to Stroke Guidelines

Reynolds, Staci Sue; Murray, Laura L.; McLennon, Susan M.; Bakas, Tamilyn

Journal of Neuroscience Nursing: December 2016 - Volume 48 - Issue 6 - p 328–335
doi: 10.1097/JNN.0000000000000237

ABSTRACT Background: Nurses play an integral part in providing evidence-based care to patients with stroke, yet some patients receive unnecessary or even harmful care. The literature supports the use of multifaceted strategies to promote implementation of evidence-based practice; however, there is a gap in knowing which combinations of strategies are most successful. Purpose: The purpose of this study was to determine if a tailored, multifaceted Stroke Competency Program would improve nurses’ knowledge of and adherence to evidence-based practices in the care of patients with stroke. This program bundled implementation strategies of local opinion leaders, printed educational materials, and educational outreach. Methods: This study used a pretest/posttest program design. Nursing adherence was measured via documentation audits with knowledge measured by an author-developed assessment. Findings: Most participating nurses had approximately 10 years of nursing experience and were baccalaureate prepared; participation ranged from 32% to 58% (n = 88). Overall, an improvement in nursing adherence was noted after the program as well as significant improvements in nursing knowledge. Conclusion: Although the Stroke Competency Program improved nursing knowledge of and adherence to stroke guidelines, future research should seek to extend these findings to identify which bundle of strategies are most effective for implementing evidence into nursing practice using psychometrically sound outcome measures.

Questions or comments about this article may be directed to Staci Sue Reynolds, PhD RN ACNS-BC CCRN CNRN SCRN, at She is a Neuroscience CNS, Duke University Hospital, and a Clinical Associate, Duke University School of Nursing, Durham, NC.

Laura L. Murray, PhD, is Professor, Department of Speech and Hearing Sciences, Indiana University, Bloomington, IN.

Susan M. McLennon, PhD RN, is Assistant Chair and Associate Professor, Indiana University School of Nursing, Indianapolis, IN.

Tamilyn Bakas, PhD RN FAHA FAAN, is Professor and Jane E. Procter Endowed Chair, University of Cincinnati College of Nursing, Cincinnati, OH.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2016 American Association of Neuroscience Nurses