Mock Stroke Code Simulation for Registered Nurses in a Rural Community Health System

Background and Purpose: Nurses play a key role in rapid identification, critical treatments, and timely care of patients with acute stroke. Although nurses are best placed to identify signs and symptoms of stroke, they may not be prepared to activate or participate in a stroke code due to lack of knowledge and self-confidence. The use of simulation in nursing education can increase knowledge and self-confidence when caring for acutely ill neurological patients. The purpose of this quality improvement project was to evaluate if participation in mock stroke code simulation increased a registered nurse’s perception of knowledge and self-confidence when engaged in a stroke code in an acute care rural community hospital.
Methods: This study was a quality improvement project using a pre- and post-intervention to measure a nurses’ knowledge and self-confidence after participating in a single 4-hour mock stroke code high-fidelity simulation. Participants completed a pre- and post- simulation questionnaire assessing stroke knowledge and self-confidence.
Results: 11 registered nurses participated in the quality improvement project. There was significant improvement (p < .001) in both knowledge and self-confidence scores pre- to post-simulation.
Conclusion: Participation in a single high-fidelity mock stroke code simulation showed improvement in knowledge and self-confidence scores in a rural community hospital. Based on the results of this quality improvement project, a study evaluating nurse led stroke code teams working with emergency department or tele-medicine physicians in underserved or non-stroke certified hospitals could be conducted to evaluate the impact on management of care on acute stroke patients in rural or underserved areas.