Implementation of a Stroke Competency Program to Improve Nurses’ Knowledge of and Adherence to Stroke Guidelines

ABSTRACT Background: Nurses play an integral part in providing evidence-based care to patients with stroke, yet some patients receive unnecessary or even harmful care. The literature supports the use of multifaceted strategies to promote implementation of evidence-based practice; however, there is a gap in knowing which combinations of strategies are most successful. Purpose: The purpose of this study was to determine if a tailored, multifaceted Stroke Competency Program would improve nurses’ knowledge of and adherence to evidence-based practices in the care of patients with stroke. This program bundled implementation strategies of local opinion leaders, printed educational materials, and educational outreach. Methods: This study used a pretest/posttest program design. Nursing adherence was measured via documentation audits with knowledge measured by an author-developed assessment. Findings: Most participating nurses had approximately 10 years of nursing experience and were baccalaureate prepared; participation ranged from 32% to 58% ( n = 88). Overall, an improvement in nursing adherence was noted after the program as well as significant improvements in nursing knowledge. Conclusion: Although the Stroke Competency Program improved nursing knowledge of and adherence to stroke guidelines, future research should seek to extend these findings to identify which bundle of strategies are most effective for implementing evidence into nursing practice using psychometrically sound outcome measures.