Refining clinical assessment with NIH Stroke Scale
Learn to better gauge the reliability and validity of stroke severity assessment findings using the NIH Stroke Scale.
Although it was originally designed as a research tool for measuring data on patients in stroke clinical trials, the National Institutes of Health (NIH) Stroke Scale has come to be relied upon more and more by stroke professionals as a clinical assessment tool for evaluating the acuity of stroke patients, determining the appropriate treatment and predicting the outcomes for those patients.
It is worth noting the scale is not without its limitations, some of which will be highlighted in the session “Leveraging the National Institute of Health (NIH) Stroke Scale Knowledge and Skills.”
Randi Toumbs, RN, clinical specialist for the stroke and neurology service at Memorial Hermann Hospital in Houston, will lead a discussion focusing on a number of tricky areas for consideration, including which patients are appropriate and when to use the assessment tool, how to perform a comprehensive assessment of the eyes, and understanding the physiologic alterations associated with visual neglect and extinction.
“These areas are very detailed and common causes of questions among clinicians in performing the assessment,” Toumbs said.
As mentioned, there is wider use of the NIH Stroke Scale. Additionally, there are regulatory requirements for the use of the NIH Stroke Scale in primary stroke centers of care to maintain their credentialing status.
The convergence of the assessment complexity in scoring a patient’s stroke severity using the NIH Stroke Scale in conjunction with the impetus of increasing the number of institutions seeking regulatory compliance provides an important educational opportunity. The Stroke Nursing Program Committee developed this session for the International Stroke Conference in order to provide a learning forum for stroke providers with the goal of improving competencies in measuring stroke severity through the application of the NIH Stroke Scale.
Toumbs said she is hopeful attendees of the session will come away with not just a better understanding of the history of the stroke scale but how to better gauge the reliability and validity of stroke severity assessment findings using the NIH Stroke Scale as well as other tools to consider to quantify stroke patient disposition.
Skye Coote, BN, senior project manager for clinical education at the Australian Stroke Alliance in Melbourne, will give an overview of how to measure stroke severity using the NIH Stroke Scale. Her presentation will also include why the scale is used, when and discerning which patients are most appropriate for the application of the scale in the clinical setting. Following the session, attendees will be able to describe the history and psychometric properties of the scale, identify patient diagnoses suitable for using the scale and discuss the limitations of scoring using the scale.
Alicia Richardson, MSN, clinical nurse specialist at Penn State Health’s Milton S. Hershey Medical Center in Hershey, Pennsylvania, will explore gaze and visual field disorders. Following her presentation, attendees will be able to distinguish gaze disorder findings in anterior versus posterior circulation, describe visual field disorder findings associated with anterior and posterior circulation stroke, and correctly score the NIH Stroke Scale to reflect deficits in gaze and visual field disorders.
In addition, Dawn Meyer, PhD, associate professor of neurosciences at the University of California-San Diego School of Medicine, will talk about the importance of not neglecting extinction disorders. Attendees will be able to describe the physiologic alterations associated with neglect syndromes, distinguish visual neglect and gaze preferences from visual field and gaze disorders and correctly score the NIH Stroke Scale to reflect deficits in extinction disorders by the end of the session.
“We hope attendees will have better insight into the NIH Stroke Scale and learn how to avoid common pitfalls in some of the trickier assessment components,” Toumbs said.
See the Online Program Planner for specific programming information.
For more ISC 2022 coverage, visit International Stroke Conference Coverage.
