A study of a continuing education program on neurological assessments of the acute stroke patient and the effect on clinical nursing practice

• Main Author: Curley, Catherine R
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2016
• Subjects: Algorithms; Data Analysis; Educational evaluation; Educational Needs; Learning Processes; Learning Strategies; Medical Evaluation; Nursing; Professional Education
• ISBN: 9781369520507; 1369520506

Professional nurses are expected to participate in ongoing educational updates to enhance practice, to refresh skills, and to incorporate new information into patient care. Continuing education requirements are mandatory in most states and particularly stringent for specialty nursing care areas. The American Stroke Association has established practice standards in the care of the acute stroke patient along with continuing education requirements. The goal of these standards is to maintain a consistent response by medical and nursing staff in the care of stroke patients. One of the most significant standards is the neurological assessment of the stroke patient on an every four hour basis from the onset of stroke symptoms. This is a requirement that is included in continuing education programs and stroke practice guidelines. The rationale for requiring stroke continuing education is the improvement of practice and overall quality of patient care. Nursing research includes studies related to the knowledge attained from continuing education, yet information is not readily available about the actual transition into practice. The purpose of this study was to evaluate the effectiveness of neurosciences education sessions on knowledge of neurological assessment and the adherence to an evidence-based clinical practice guideline in professional nurses working with acute stroke patients. Meleis’ Transitions Theory provided the theoretical framework for this study, identifying role transitions and the barriers to implementing change in achieving the assimilation of knowledge to practice. A pre test, post test quasi-experimental design was employed for this study. Knowledge of the course content was analyzed at three points, immediately pre and post session and in one month. The evaluation of the assimilation into practice was determined with the medical record analysis of a random sample of registered nurses who participated in the educational intervention and testing. Due to an inability to obtain a sufficient sample of both the face-to-face group (n = 6) and the online group (n = 108), data were combined for analysis. Analyses of the pre test in comparison to the immediate post test and comparison of immediate post to one month post test scores were not statistically significant for a difference in knowledge. Inspection of the electronic medical record audit data (N = 26); however, showed a significant increase in adherence to the neurological assessment protocols from pre education to post education (p = .023) audits. Limitations of the study included this researcher’s decision to use only one health system which may have hindered the ability to capture a larger sample. Another limitation was the inability to recruit a sufficient sample of nurses for the face-to-face format group as the nurses in this facility overwhelmingly preferred an online option. The findings of this study are important to nursing science research, education, and practice. The resultant preference by nurses in this study to access continuing education in an online format provides evidence that could guide clinically based educators. Knowledge development in nursing education and its relevance to practice and patient outcomes is an area that would benefit from this and continued research. The findings of this study emphasize the need for nursing research to expand beyond an assessment of knowledge after an educational intervention. Identifying the impact of education practice through nursing research may provide empirical evidence of the impact of continuing education on knowledge assimilation and expert clinical practice.