Abstract NS2: Post Stroke Assessment Tool for Nurses Validated

Abstract

Introduction: Nurses who provide inpatient care to acute ischemic stroke (AIS) patients routinely perform neurologic assessments that are intended to monitor the stability of neurological deficit. A variety of assessment tools are used, however none of these tools have been validated as a stroke specific assessment tool for nurses. The purpose of this study was to evaluate the validity of a novel nurse performed stroke assessment tool, the Post Stroke Assessment Tool (PSAT). Methods: An interdisciplinary team, from a single certified primary stroke center devised the PSAT. The PSAT encompasses evaluation of 4 components of neurologic function (level of consciousness, cranial nerves, limb strength, and limb coordination). PSAT scores range from 0 (no deficits) to 63. A Clinical Nurse Educator trained neurology nurses on PSAT performance prior to study initiation. A nurse performed the PSAT on patients with AIS. A physician performed the National Institutes of Health Stroke Scale (NIHSS) within 30 minutes of PSAT completion. General linear regression and Pearson correlation was used to evaluate the relationship between scores. All analysis was done in SAS® Version 9.3 for Windows. Results: A total of 26 nurses conducted a PSAT on 46 patients. Mean NIHSS was 6.1 (S.D. +/- 6.9) and mean PSAT score was 10.2 (S.D. +/- 11.8). The r 2 was 0.8349. Overall, the model was significant (p-value < 0.0001). Both the regression model and Pearson correlation showed a significant relationship between PSAT and NIHSS (p <0.0001 for both). Spearman correlations showed a significant relationship between PSAT and NIHSS within each category (p < 0.003 for each category). Conclusions: In this exploratory study, the PSAT appears to be a reliable nursing assessment tool to monitor post stroke neurologic deficit. Total and categorical PSAT scores highly correlated with total and categorical NIHSS scores. No attempt to compare inter-rater reliability from one nurse to another was included in this study. Future research concerning the reliability of the PSAT will be necessary before this tool can become a standard nursing assessment for patients following AIS.