University Hospitals Comprehensive Stroke and Cerebrovascular Center (UHCSCC) Registered Nurses (RNs) in the Neurological Intermediate Unit (NIU) often care for patients after Intravenous (IV) tissue plasminogen activator (tPA) has been initiated. IV tPA is a high-alert medication that has potential bleeding risks. Due to the limited opportunity for initiating IV tPA, we identified the need for enhanced education among this group of RNs. Currently, NIU RNs complete an annual competency via an online learning management system (LMS). Our goal is to identify the best teaching method to heighten the ability for the RNs to retain and apply information. This project is to evaluate if an individualized hands-on educational approach improves the RN’s knowledge of IV tPA administration. In 2015, 36 NIU RNs were given a 20 question pretest that assessed their baseline knowledge on dosing, administration, monitoring, and complications of IV tPA. Each RN then completed the annual LMS competency. Eighteen RNs from this group were randomly selected to participate in an additional 30 minute one-on-one instructional session that included both verbal information and hands-on practice. Approximately 2 weeks later, all 36 RNs completed a 20 question post test to assess knowledge retention. All of the 36 NIU RNs had some education on IV tPA prior to this study. The years of experience working as an RN varied from 6 months to 20 years. Group 1 consisting of 18 RNs that solely received LMS education averaged 50.8% on the pretest and averaged 83.3% on the post test. Group 2 consisting of 18 RNs that had the additional hands-on educational session averaged a 42.2% on the pretest and averaged 95.8% on the post test. The data was analyzed using paired t-tests, and the difference in scores were significant for both groups (P=0.000). Additionally, a 2-sample t-test found significant difference (P=0.004) in the score changes from pre to post when comparing hands-on instruction to the LMS training. Both methods of education were associated with significant increased scores on the post test. Our data suggests that the hands-on approach along with our current practice improves knowledge retention. Further research would be useful to assess retention several months post education.