Background: Training nurses to perform the National Institutes of Health Stroke Scale (NIHSS) exam can be expensive, as traditionally this involves going to an on-line training site and watching videos, then scoring patients in a test environment. Our organization pays nurses in the ICU and stroke unit for 3 hours of self-learning time annually in order to stay current with this certification. When the decision was made to expand this certification to the observation unit, there was concern about the additional costs of “unproductive time” to complete the learning. In addition, nurses have anecdotally expressed dissatisfaction with the on-line learning platform.
Purpose: The purpose of this project was to develop a training program for nurses to learn the NIHSS exam in a manner that is both meaningful and cost effective. Our goal was to reduce the amount of time spent on training and provide an in-person experience that nurses would find more relevant to their everyday practice.
Methods: We identified content experts already embedded in the stroke program to act as trainers. Subject nurses were then provided with three baseline training videos to provide an overview of the exam, followed by live education with tips to overcome common challenges. Finally, our content experts observed them performing the exam to determine their competence.
Results: We designed a learning program that reduces the amount of time spent on training from 3 hours to 1 hour. Additionally, 92% of nurses interviewed as part of this project described a preference for learning through in-person training rather than the on-line version. This project is ongoing, but at the conclusion, we will collect data related to the nurses’ perception of and satisfaction with this style of learning. There is also a plan to model this training method in the ICU and stoke unit which will result in a two thirds cost savings over our current model.
Conclusion: In the current healthcare climate where we need to be good stewards of our time and resources, redesigning a training program in a way that is efficient, cost effective, and perceived as a preferred style of learning will benefit our stroke program, as these nurses will have the skills and confidence they need in caring for stroke patients.