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Weekly UpdatesWhen choosing which stroke scale to implement in acute care, the committee elicited feedback from staff nurses, the majority of whom considered the CNS assessment faster and easier to use than the NIHSS. This was of particular importance to the staff, given that hourly neurological assessments are common in work with acute neurological patients. Yet nurses still said that the CNS was not easy to use in practice. Although both the CNS and the NIHSS are validated stroke assessment tools to use at a specific time, they have not been validated in a prospective manner as monitoring tools. Future studies should address the validity and reliability of these stroke assessment tools for capturing change in patients when used on a frequent basis.
Conclusion
Although nurses are aware of BPGs, a belief in their value is necessary to translate into changes in practice, and these changes take time. Implementation of any new stroke assessment scale should include the opportunity to practice the skill with feedback and requires an evaluation component so that adjustments can be made to best meet the needs of users.
Acknowledgments
The authors would like to thank the Registered Nurses Association of Ontario for providing a grant for the data entry and analysis and the Southwestern Ontario Stroke Network for funding the workshop. We would also like to acknowledge all of the staff nurses who participated in the evaluation, as well as the following committee members who developed the workshop and implementation process: Bronia McDougal, Cathy O'Brien, Kim Salway, and Kim Staikos.
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Questions or comments about this article may be directed to Breeda O'Farrell, MScN TCNP CNN(C) RN, at Breeda.ofarrell@lhsc.on.ca. She is an advanced practice nurse in neurology at the University Hospital, London Health Sciences Centre, London, Ontario, Canada, and an associate professor at the School of Nursing at the Faculty of Health Sciences Centre at the University of Western Ontario, London, Canada.
Guang Yong Zou, PhD, is an assistant professor in the department of epidemiology and biostatistics and a scientist with Robarts Clinical Trials at the Robarts Research Institute at the Schulich School of Medicine and Dentistry at the University of Western Ontario, London, Canada.
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