The Effect of Stroke Metric Documentation Education on Stroke Metric Knowledge and Documentation Compliance

Abstract

Compliance with stroke metrics is positively associated with improved health outcomes for patients recovering from acute stroke. Accurate and thorough nursing documentation of stroke metrics during this critical period is vital for the interdisciplinary team. This documentation provides accurate monitoring of the condition of the patient and guides treatment interventions. Since the COVID-19 pandemic, the project site hospital stroke stepdown unit has dually, and at times, solely functioned as a unit that cares for COVID-19 patients. As a result, the focus on nurse-driven stroke metric documentation has declined. This quality improvement project was designed to assess if a stroke documentation educational intervention for registered nurses (RNs) on a stepdown stroke unit could affect their documentation compliance and knowledge of nurse-driven stroke metrics. The project used a combination of an educational video and reminder card to reinforce nurse-driven stroke metric knowledge and documentation compliance. The video reviewed where and when to document the following nurse-driven stroke metrics in patients’ electronic health records (EHR): dysphagia screening, stroke education, smoking cessation, utilization of sequential compression devices, neurological assessments, and the National Institutes of Health Stroke Scale. A pre- and post-survey was used to measure nurse-driven stroke metric knowledge before and after the educational video. Results from the post-survey showed a statistically significant increase in knowledge, Z = 3.04, p = .002. Patient EHR chart audits measuring nurse-driven stroke metric documentation compliance before and after the educational interventions did not show any statistically significant changes in documentation compliance. The results of this project demonstrate that a multi-modal educational intervention can be used to increase knowledge of a topic.