Abstract 3074: Acute Stroke Nurse Response Pilot Program

Background: Less than 10% of ischemic stroke patients receive tissue plasminogen activator. Low treatment rates have been associated with delay in hospital presentation and reluctance to treat. Studies have found that a combination of community and professional education increase thrombolytic therapy from 2.2% to 11.3% with the data suggesting that professional education made the most impact. An Acute Stroke Nurse Response educational program was piloted as a means of providing specialized treatment education for nurses in North Carolina. Project goals: A. Increase the number of nurses across the state experienced to provide acute stroke assessment and treatment. B. Determine the best educational approach: on-line vs. class room vs. both. C. Develop a mock code stroke training module. D. Provide guidance in developing individualized models of stroke care protocols. Measurable objectives: A. Gauge interest in the program. B. Assess pre and post-test knowledge measuring effectiveness of modules. C. Assess nurse preference for teaching method. D. Evaluate the methodology of the mock code stroke module. Methods: The educational program covered stroke topics through on-line modules and a one day lecture series to meet the needs of the working nurse. The program consisted of 10 specialized stroke training modules: Module 1: Introduction to Stroke Module 2: Emergency Management Module 3: Acute Stroke Treatment Module 4: Management of ICH Module 5: Stroke Prevention Module 6: Nursing Care of the Stroke Patient Lecture 7: Neurological Assessment Lecture 8: Stroke Imaging Lecture 9: Quality Improvement/Joint Commission Primary Certification Lecture 10: Mock Stroke Code 6 weeks were allowed to complete the on-line modules prior to the day lecture series. Pre and post-test exams were administered to assess baseline knowledge and knowledge gained. Results: 42 nurses showed interest in the program. 12 nurses completed the pilot program. 10 were from NC, originating throughout the state and 2 from SC. Two participants were NP’s, 2 ED nurses, 3 staff nurses and 5 stroke coordinators. Participants had a mean pre-test score of 53.2, which increased significantly (p<0.001) to a mean post-test score of 77.8 (absolute mean improvement of 24.6%). The improvement in the scores ranged from 11.1 to 44.5% with one participant experiencing a decrease in test scores by 5.6%. Program feedback was positive, with strengths identified as “convenient and informative”. All participants requested the program continue as originally developed with on-line modules and the one day lecture series. Conclusions: There was a significant educational benefit from this program, as demonstrated by participant responses to the pilot program.