The Effect of a Simulation-Based Education Program on NIHSS Accuracy and Inter-Rater Reliability Among Nursing Staff in the Neurological/Neurosurgical Intensive Care Unit
Year of Publication
Doctor of Nursing Practice
Dr. Carol Thompson
Dr. Nicholas Welker
Dr. Jennifer Dent
PURPOSE: The purpose of this Quasi-experimental study was to examine the effect of a simulation-based educational NIHSS workshop on nursing accuracy and inter-rater reliability upon use of the National Institutes of Health Stroke Scale (NIHSS).
METHODS: This study was conducted in the Neurological/Neurosurgical Intensive Care Unit (ICU) at Baptist Health, a comprehensive stroke center located in Lexington, KY. The sample included 26 eligible nurses employed in the aforesaid unit. Nurses completed the NIHSS on a patient actor in a simulated scenario (this session was videotaped), a one-on-one debriefing with review of the videotape was conducted afterward, and then the nurse completed the NIHSS on a patient actor in a second scenario.
RESULTS: Four participants scored the patient correctly in scenario one, and nineteen participants scored the patient correctly in scenario two. However, the results were not deemed statistically significant (P=.287, Fisher’s Exact Test). Variability of scoring did improve from scenario 1 to scenario 2 (SD=1.74 and 0.53, respectively). Inter-rater reliability among participants was also shown to increase in scenario 2, with noted differences in five items on the NIHSS.
CONCLUSION: NIHSS simulation-based education was shown to improve accuracy of scoring (SD=1.74 pre-intervention and SD=0.53 post-intervention) and inter-rater reliability (significant results seen in five distinct scale items) of participants. More research is needed to determine if simulation-based NIHSS education has an effect on patient outcomes.
Novak, Amanda, "The Effect of a Simulation-Based Education Program on NIHSS Accuracy and Inter-Rater Reliability Among Nursing Staff in the Neurological/Neurosurgical Intensive Care Unit" (2019). DNP Projects. 271.