Abstract TP381: What Does It Take? How to Obtain Nursing Buy-in and Compliance of Neurological and Vital Sign Assessments and Re-assessment for the Stroke Patient

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Background: Prior to intervention, the average stroke patients’ neurological and vital sign assessments were not completed according to the facility’s clinical practice guidelines. This led to lost interventional opportunities as nurses failed to recognize subtle changes in their patient’s condition. This issue is a common challenge discussed among Stroke Coordinators nationwide.

Purpose: To ensure 90% or greater compliance with neurological assessments, vital sign assessments and documentation. To empower nurses to internalize their ability to create a positive outcome for stroke patients.

Method: The existing policies and clinical practice guidelines were sound and based on the American Heart Association / American Stroke Association guidelines. Staff education was conducted via the facility intranet, email, newsletters and staff meetings. A goal of 100% attendance of appropriate staff at education session within 30 days was established, conducted and met.

Results: The facility established the goal of 90% compliance with frequency of ordered neurological checks and vital signs within 4 months as shown by documentation. In less than one month, due to the nurses’ recognition of their ability to make effective interventions in new onset strokes, the facility achieved 99% compliance. The previous compliance baseline was 57%; by July, we had attained 99% compliance.

Conclusion: By providing nursing staff education on their ability to provide timely interventions based off of maintaining ordered vital sign and neuro check frequency, the nurses realized that they could make a difference. With this simple approach, using the hands-on staff and including them in the massive educational campaign, the facility realized a fast change in compliance with policy and protocols. Allowing the nursing staff who actually preformed the activity to have control, accountability and input resulted in quick, effective change with positive patient outcomes. Allowing them to mold their tools gave them empowerment that helped them to internalize satisfaction in their practice.

Key words: Interventional opportunities, Empowerment, Internalized, Bedside nurse, Peer accountability, Patient safety

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