Neuroscience Nursing Interventions and Outcomes in Acute Ischemic Stroke Patients Outside the Intensive Care or Rehabilitation Unit: A Scoping Review

ABSTRACT BACKGROUND: Neuroscience nurses generate new knowledge through research. Establishing research priorities is essential to support evidence-based nursing practice and direct research agendas. The purpose of this scoping review was to describe the nursing interventions and outcomes of adult 18 years of age or older nonintensive care or rehabilitation hospitalized patients with acute ischemic stroke (AIS) and identify gaps in the evidence. METHODS: Scoping review was followed, which included creation of a structured review protocol, a comprehensive librarian-assisted literature search of studies from 2010 to 2023, and the use of systematic review software. Reviewers performed title, abstract, and full-text review of studies meeting the inclusion criteria. A structured data extraction form was used to record characteristics of included studies, as well as nursing interventions and outcomes for hospitalized patients with AIS. RESULTS: Of the 797 studies identified from the literature search, 35 studies met the inclusion criteria. Nursing interventions included specific activities related to motor functioning (13), patient and family education (7), dysphagia (8), workflow (3), management of hyperglycemia (3) and fever (3), and discharge planning (1). Clinical outcomes included measures of disability (20), mortality (17), neurological deficits (15), adverse events and complications (14), and length of stay (14). Additional less frequently reported outcomes included time (9), patient satisfaction (6), and unplanned emergency department visits and readmissions (1). No studies reported metrics related to return on investment or costs related to nursing interventions. Across all interventions, motor functioning appears to have a positive impact on length of stay, neurological deficits, disability, and timing. CONCLUSION: This review provides a summary of nursing interventions and outcomes for adult hospitalized patients with AIS from a small sample of studies over 20 years. Gaps in the literature are noted to help inform the American Association of Neuroscience Nurses on the need for future research.