Paper
Thursday, 20 July 2006
This presentation is part of : Nursing Education Projects and Studies
The Use of National Institutes of Health Stroke Scale in Stroke Care Professionals in Taiwan
Guey Y. Jeng, RN1, Su C. Chiou, RN, BS1, Tzu K. Sun, RN1, Shu H. Yeh, PhD2, Ting Y. Chen, MD3, Tsu K. Lin, PhD4, and Ku C. Chang, MD5. (1) Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan, (2) Department of Nursing, Chang Gung Institute of Technology at Kaohsiung, Kaohsiung, Taiwan, (3) Department of Neurology, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan, (4) Department of Neurology, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan, (5) Department of Neurology, Medical College, Chang Gung University, Linko, Kaohsiung, Taiwan
Learning Objective #1: learn the factors related to the use of NIH Stroke Scale in stroke care professionals.
Learning Objective #2: realize nursing staff in non English speaking area, as in Taiwan, reported language barrier in the use of NIH Stroke Scale.
Background:
National Institutes of Health Stroke Scale (NIHSS) is an easy performed and standardized tool evaluating neurological deficits for stroke.  However, the incidence and factors related to the use of the scale in stroke care professionals were not clearly described.
Purpose:
Explore the incidence and factors related to the use of NIHSS in stroke care professionals in Taiwan.
Methods:
A structured questionnaire investigating the cognition (7 items with Likert scale: 1=strong disagree, 5= strong agree), attitudes (3 items; 1=strong disagree, 5= strong agree) and behaviors (4 items for nurses and 3 items for neurologists; 1=never, 4= always) in use of NIHSS was developed. The content validity index was .72-.96 and Cronbach's α .89-.97.
By convenience sampling, 335 stroke care professionals from eight hospitals in Taiwan were selected. The response rate of neurology nursing staff was 80.9% (188 of 255) and neurologists 77.1% (62 of 80).
Results:
There were 18% of the nursing staff and 90% of the neurologists ever used the scale (p<.01).  As compared with only 27% of nursing staff, 82% of neurologists had been certificated to use NIHSS (p<.01).  Responders agreed that the scale was important and good for stroke care. (nurses (mean) 3.8±0.7; neurologists 3.9±0.7).  However, language barrier was recognized (nurses 3.7±0.9; neurologists 3.2±1.1, p<.03) in the use of the English scale.  Responders agreed to learn and use the scale. (nurses 3.8±0.8; neurologists 4.4±0.6, p<.05).  However, the NIHSS was not frequently used (nurses 2.6±0.8; neurologists 2.7±0.8).  The NIHSS score was less recorded in chart(nurses 2.3±1.0; neurologists 2.6±0.8).
Conclusions:
A valid local language, such as mandarin version in Taiwan, of the NIHSS; modified format of medical records; and training activities will facilitate the use of the NIHSS in the stroke care professionals.

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