Successful Implementation of the National Institutes of Health Stroke Scale on a Stroke/Neurovascular Unit

Richardson, Jenna; Murray, Diana; House, C. Ken; Lowenkopf, Ted J

doi:10.1097/01376517-200609000-00007

Cited by 14 publications

(7 citation statements)

References 16 publications

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“…Pocket cards appeared to be a popular method of learning and reinforcing the practice change. This is consistent with previous literature demonstrating the effectiveness of pocket cards as part of educational strategies for implementation of new clinical practices and to improve health care provider knowledge (Blanco et al 2005;Richardson et al 2006;Mikhael et al 2008). Pocket cards are inexpensive, easily implemented and readily available educational tools.…”

Section: Discussionsupporting

confidence: 77%

Clinicians prefer simple educational tools for implementing practice change

Jefferies

Shah

2011

Medical Teacher

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Background: Successful implementation of practice change requires educational tools that engage and motivate clinicians. Aim: To examine clinician usage and preference for different educational tools when a multifaceted strategy was used for implementation of new recommendations for managing newborns at risk of sepsis. Methods: Seminars, web-based tutorial, handouts, pocket cards and web-based management algorithm were used to educate health professionals. Ninety-two clinicians attended seminars and completed feedback questionnaires that included three questions assessing knowledge of the recommendations. After 3 months, an electronic survey containing the same questions was sent to 41 key stakeholders (staff neonatologists, trainee physicians, nurse practitioners and respiratory therapists) who provided patient care during the implementation period. Compliance with recommendations was assessed by chart audit. Results: Seminar content was helpful to 97% of participants and 88% were comfortable using the recommendations. Response rate for the 3-month survey was 80%. The most frequently used and useful tools were pocket cards (76%) and seminars (76%); 79% continued to use the card. Only one respondent used the web tutorial and four used the algorithm. There was no significant difference in percent correct responses to the questions between the two timepoints ( p 4 0.05). Compliance with the recommendations was 83%. Conclusions: When provided with different educational tools, clinicians prefer pocket cards and seminars -tools that are simple and readily accessed.

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Section: Discussionsupporting

confidence: 77%

Clinicians prefer simple educational tools for implementing practice change

Jefferies

Shah

2011

Medical Teacher

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“…The NIHSS was originally developed for the alteplase pilot trials, 99 has been validated in many studies, [100][101][102] and can be used by health professionals with various levels of training. 103,104 Some literature suggests that the NIHSS is weighted more toward language deficits, hence giving higher scores to left compared with right hemispheric ischemic strokes with equivalent volumes of infarct. 105 Although the NIHSS was developed by the investigators of the original 2 NINDS alteplase trials, the exclusion criteria for minor stroke were not based purely on the NIHSS.…”

Section: Stroke Severity and The Nihssmentioning

confidence: 99%

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Demaerschalk¹,

Kleindorfer²,

Adeoye³

et al. 2016

Stroke

564

237

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Purpose-To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administration under selected commonly and uncommonly encountered clinical circumstances and to identify future research priorities concerning these eligibility criteria, which could potentially expand the safe and judicious use of alteplase and improve outcomes after stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge and, when appropriate, formulated recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive American Heart Association internal peer review, Stroke The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 24, 2015, and the American Heart Association Executive Committee on October 5, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@ wolterskluwer.com.The online-only Data Supplement, which contains literature search strategies and Figures A, B, and C, is available with this article at http://circ. ahajournals.org/lookup/suppl/doi:10.1161/STR.0000000000000086/-/DC1.The American Heart Association requests that this document be cited as follows: Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, Khalessi AA, Levy EI, Palesch YY, Prabhakaran S, Saposnik G, Saver JL, Smith EE; on behalf of the American Heart Association Stroke Council and Council on Epidemiology and Prevention. Scientific rational...

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“…27 Nurses in the Stroke Unit should have experience and expertise in performing serial neurological assessments using the National Institutes of Health Stroke Scale or a similar validated tool. 91 There should be a written protocol that details how changes in a patient's status are detected, how they are documented, and how medical staff are notified of such changes. 92 For example, a standard protocol might include vital signs every 1 to 2 hours for 24 hours after admission and neurological checks (using the National Institutes of Health Stroke Scale or similar assessments) every 2 to 4 hours.…”

Section: Stroke Unitmentioning

confidence: 99%

Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

Alberts

Latchaw

Jagoda

et al. 2011

Stroke

195

167

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for the Brain Attack CoalitionBackground and Purpose-The formation and certification of Primary Stroke Centers has progressed rapidly since the Brain Attack Coalition's original recommendations in 2000. The purpose of this article is to revise and update our recommendations for Primary Stroke Centers to reflect the latest data and experience. Methods-We conducted a literature review using MEDLINE and PubMed from March 2000 to January 2011. The review focused on studies that were relevant for acute stroke diagnosis, treatment, and care. Original references as well as meta-analyses and other care guidelines were also reviewed and included if found to be valid and relevant. Levels of evidence were added to reflect current guideline development practices. Results-Based on the literature review and experience at Primary Stroke Centers, the importance of some elements has been further strengthened, and several new areas have been added. These include (1) the importance of acute stroke teams; (2) the importance of Stroke Units with telemetry monitoring; (3) performance of brain imaging with MRI and diffusion-weighted sequences; (4) assessment of cerebral vasculature with MR angiography or CT angiography; (5) cardiac imaging; (6) early initiation of rehabilitation therapies; and (7) certification by an independent body, including a site visit and disease performance measures. Conclusions-Based on the evidence, several elements of Primary Stroke Centers are particularly important for improving the care of patients with an acute stroke. Additional elements focus on imaging of the brain, the cerebral vasculature, and the heart. These new elements may improve the care and outcomes for patients with stroke cared for at a Primary Stroke Center. (Stroke. 2011;42:2651-2665.)

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Successful Implementation of the National Institutes of Health Stroke Scale on a Stroke/Neurovascular Unit

Cited by 14 publications

References 16 publications

Clinicians prefer simple educational tools for implementing practice change

Clinicians prefer simple educational tools for implementing practice change

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

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