Authors (including presenting author) :
Chui KS(1), Mok M(1), Chan YS(1), Lo HY(1), Ho PC(1), Doung KH(1), Li R(1), Cheng WHS(1), Ho E(1)(2), So HM(2), Tsoi SCT(2)(3), Cheung CM(1)
Affiliation :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital (PYNEH)
(2)Nethersole Clinical Simulation Training Centre, Hong Kong East Cluster (HKEC)
(3)Nursing Services Division, Pamela Youde Nethersole Eastern Hospital (PYNEH)
Introduction :
Prompt recognition and protocol-driven management of acute stroke are critical to improving patient outcomes, yet many nurses lack comprehensive training and alertness in this area causing delay treatment for in-patient stroke. ‘In-patient Stroke Emergency Care Simulation Training Program’ has been conducted for nurses since 2021, aiming to increase nurses’ awareness of in-patient stroke and consolidate stroke management.
Objectives :
To evaluate the effectiveness of simulation-based stroke emergency training program in improving nurses' knowledge, confidence in identifying stroke and promptly carry out corresponding actions
Methodology :
A comprehensive stroke emergency simulation training program was implemented for nurses in HKEC annually since 2021. The program included interactive case-based scenarios covering stroke symptom recognition, nursing assessment, reporting to stroke nurse and physicians, hyper-acute stroke treatment, and post-stroke management. Nurses from various departments and hospitals of HKEC were invited to participate annually. Knowledge assessment, self-reported confidence, stroke alert response times, thrombolysis administration rates, and were evaluated before the program and at the end of each year.
Result & Outcome :
Total 139 nurses completed the stroke simulation training over 4 years. Simple knowledge assessment scores improved significantly from baseline (mean score 39% to 72.8%, p< 0.001). Self-reported confidence in stroke management increased from a mean of 3.63 to 5.31 on a 6-point scale (p< 0.001). Mean time from stroke alert activation to Computed Tomography (CT) imaging decreased from 81.8 minutes to 68.4 minutes (p< 0.001), and the proportion of eligible patients receiving thrombolytic therapy within timeframe increased from 5.4% to 15.4% (p< 0.001). Importantly, the number of in-patient strokes identified by nurses increased by 39% over the 4-year period.
Conclusion:
A comprehensive stroke emergency simulation training can lead to sustained improvement in nurses' knowledge, confidence, and adherence to evidence-based stroke care guidelines. This educational intervention was associated with enhanced in-patient stroke recognition and shortened stroke discovery to CT time, suggesting it could contribute to better acute stroke outcomes.
Public Health Implications:
Simulation-based training should be a key component of ongoing in-patient stroke awareness promotion campaign. More training sessions and further expansion of target group in different departments in HKEC may improve quality of in-patient stroke management and outcome of these patients.
