Neurological Nursing Assessment Education at Intermountain Medical Center: A Quality Improvement Project

Abstract

Background and Aims: Nursing assessments are an integral part of the nursing process that may have significant impact on patient outcomes. Nursing assessments often identify potentially life threatening conditions such as acute neurological events. Inconsistencies of neurological assessments can occur for nurses who do not routinely perform these exams; furthermore, nurses need to be able to identify normal vs. abnormal neurological findings. The Aims of this project were to deliver neurological assessment education and assess nurses’ 1) ability to identify neurological assessment components 2) ability to identify normal vs. abnormal neurological findings and 3) and their perceptions of a one-time face-to-face neurological assessment education. Design, Setting and Population: This quality improvement project uses a descriptive study design. The study took place at Intermountain Medical Center (IMC) in Murray, Utah. Full time nurses (N=31) from medical surgical units participated in the study. Methods and Data Analysis: A 40 minutes neurological assessment PowerPoint education modules was developed and presented in lecture format in five different sessions. A 17 question pre- and 17 question post-education survey was conducted at the time of the education. Overall pre- and post-survey scores and scores representing ability to identify neurological assessment components and normal vs. abnormal assessment findings were described as means +/-SD and compared using t-tests. Perceptions of the education were assessed using a Likert scale. Results: There was a significant increase in overall post-survey scores (88.6+/-13.3) vs. pre-survey scores (77.2+/-16.7) (p=0.001). After the education, there was significant increase in the ability to identify neurological assessment components (p=.002) and a significant increase in the ability to identify normal vs. abnormal neurological findings (p=.004). A large percentage (90%) of the nurses perceived the education as beneficial. Conclusion: A one time, face to face neurological assessment education significantly increased the ability of medical surgical nurses at IHC to identify neurological assessment components and identify normal vs. abnormal neurologic findings. Nurses perceived the education as beneficial. Findings support the need for ongoing education for neurological assessments to increase knowledge and confidence in neurological assessment which ultimately could improve patient outcomes.