The impact of education and training interventions for nurses and other health care staff involved in the delivery of stroke care: An integrative review

Jones, Stephanie P.; Miller, Colette; Gibson, Josephine; Cook, Julie; Price, Chris; Watkins, Caroline L

doi:10.1016/j.nedt.2017.11.024

Cited by 30 publications

(25 citation statements)

References 30 publications

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“…Swift and accurate identification of stroke symptoms is therefore of paramount importance to enable prompt transport to a stroke center. Some studies suggest that the use of e-learning material enhanced both neurological assessment by nurses and quality of care in stroke teams [ 29 , 30 ]. Different e-learning tools aiming to improve symptoms recognition and global care of stroke patients are currently being developed and implemented [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Teaching the National Institutes of Health Stroke Scale to Paramedics (E-Learning vs Video): Randomized Controlled Trial

et al. 2020

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Background Prompt and accurate identification of stroke victims is essential to reduce time from symptom onset to adequate treatment and to improve neurological outcomes. Most neurologists evaluate the extent of neurological deficit according to the National Institutes of Health Stroke Scale (NIHSS), but the use of this scale by paramedics, the first healthcare providers to usually take care of stroke victims, has proven unreliable. This might be, at least in part, due to the teaching method. The video used to teach NIHSS lacks interactivity, while more engaging electronic learning (e-learning) methods might improve knowledge acquisition. Objective This study was designed to evaluate whether a highly interactive e-learning module could enhance NIHSS knowledge acquisition in paramedics. Methods A randomized controlled trial comparing a specially designed e-learning module with the original NIHSS video was performed with paramedics working in Geneva, Switzerland. A registration number was not required as our study does not come into the scope of the Swiss federal law on human research. The protocol was nevertheless submitted to the local ethics committee (Project ID 2017-00847), which issued a “Declaration of no objection.” Paramedics were excluded if they had prior knowledge of or previous training in the NIHSS, or if they had worked in a neurology or neurosurgery ward. The primary outcome was overall performance in the study quiz, which contained 50 questions. Secondary outcomes were performance by NIHSS item, time to course and quiz completion, user satisfaction regarding the learning method, user perception of the course duration, and probability the user would recommend the course to a colleague. Results The study was completed by 39 paramedics. There was a better overall median score (36/50 vs 33/50, P=.04) and a higher degree of satisfaction regarding the learning method in the e-learning group (90% vs 37%, P=.002). Users who had followed the e-learning module were more likely to recommend the course to a colleague (95% vs 63%, P=.02). Paramedics in the e-learning group took more time to complete the course (93 vs 59 minutes, P<.001), but considered the duration to be more adequate (75% vs 32%, P=.01). Time to quiz completion was similar between groups (25 vs 38 minutes, P=.12). Conclusions Use of an e-learning module shows promising results in teaching the NIHSS to paramedics.

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Section: Discussionmentioning

confidence: 99%

Teaching the National Institutes of Health Stroke Scale to Paramedics (E-Learning vs Video): Randomized Controlled Trial

et al. 2020

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“…It should be noted that while diagnostic and comorbidity scales determine the activation of the SCs, only 50.3% and 40.1%, respectively, were familiarized with them, which is similar to the finding of DiBiasio in Rhode Island [ 25 ]. An integrative review [ 26 ] on the impact of training programs on strokes found that only 1 of 21 courses was taught online. In that single UK-based study (RESPONSE [ 27 ]), there was a greater improvement in knowledge compared to our findings (95.6% vs. 82%), while the response rates varied (39% vs. 54%).…”

Section: Discussionmentioning

confidence: 99%

An Online Training Intervention on Prehospital Stroke Codes in Catalonia to Improve the Knowledge, Pre-Notification Compliance and Time Performance of Emergency Medical Services Professionals

Gorchs-Molist

Solà-Muñoz²,

Enjo-Perez

et al. 2020

IJERPH

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Strokes are a time-dependent medical emergency. The training of emergency medical service (EMS) professionals is essential to ensure the activation of stroke codes with pre-notification, as well as a rapid transfer to achieve early therapy. New assessment scales for the detection of patients with suspected large vessel occlusion ensures earlier access to endovascular therapy. The aim of this study was to evaluate the impact on an online training intervention focused on the Rapid Arterial oCclusion Evaluation (RACE) scoring of EMS professionals based on the prehospital stroke code in Catalonia from 2014 to 2018 in a pre–post intervention study. All Catalonian EMS professionals and the clinical records from primary stroke patients were included. The Kirkpatrick model guided the evaluation of the intervention. Data were collected on the knowledge on stroke recognition and management, pre-notification compliance, activated stroke codes and time performance of EMS professionals. Knowledge improved significatively in most items and across all categories, reaching a global achievement of 82%. Pre-notification compliance also improved significantly and remained high in the long-term. Increasingly higher notification of RACE scores were recorded from 60% at baseline to 96.3% in 2018, and increased on-site clinical care time and global time were also observed. Therefore, the online training intervention was effective for increasing EMS professionals’ knowledge and pre-notification compliance upon stroke code activation, and the wide adoption of a new prehospital scale for the assessment of stroke severity (i.e., the RACE scale) was achieved.

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“…This type of approach is associated with a positive impact on patient and quality-of-care outcomes among nurses and healthcare staff involved in post-stroke patient care. 12 A novel mHealth, smartphone-based, spaced-learning intervention has been shown to improve nurses' knowledge of atrial fibrillation and anticoagulation, and to influence their use of stroke and bleeding risk assessment tools in clinical practice. 13 In addition, both stroke nurse managers, who are senior nurses with specialized stroke knowledge, and stroke nursing practitioners, who undergo an advanced practice training, might usefully educate nurses on neurology units about different aspects of recommended treatment for post-stroke patients.…”

Section: Semyon Melnikovmentioning

confidence: 99%

The need for knowledge and skills in the care of post-stroke patients

Melnikov

2020

European Journal of Cardiovascular Nursing

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The impact of education and training interventions for nurses and other health care staff involved in the delivery of stroke care: An integrative review

Cited by 30 publications

References 30 publications

Teaching the National Institutes of Health Stroke Scale to Paramedics (E-Learning vs Video): Randomized Controlled Trial

Teaching the National Institutes of Health Stroke Scale to Paramedics (E-Learning vs Video): Randomized Controlled Trial

An Online Training Intervention on Prehospital Stroke Codes in Catalonia to Improve the Knowledge, Pre-Notification Compliance and Time Performance of Emergency Medical Services Professionals

The need for knowledge and skills in the care of post-stroke patients

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