Assessment of knowledge of nurses about Iran certificate of acute stroke management and triage of stroke patients in emergency department of Imam Reza hospital in Tabriz and effect of education on proper triage

Abstract

Objective: Evaluation of knowledge of triage nurses about Iran standard certificate of management of acute stroke treatment and assessment of proper triage level of acute stroke patients and activation of stroke code in emergency ward before and after education of triage nurses. Methods: This interventional study was conducted before and after education without control group. The population study were all triage nurses that have been selected among emergency nurses by cluster sampling. 41 from 60 nurses had inclusion criteria in our study. The study was conducted in one of 724 hospitals of Iran that administers rTPA; the Imam Reza hospital of Tabriz. Level of triage in stroke patients and activation of rTPA code and symptoms of patient was assessed from 245 records in two months. Then knowledge of triage nurses about Iran certificate of stroke was assessed by a questionnaire with 5 open questions. The questionnaire was designed according to check list of Iran standard certificate of stroke. Afterwards the education to nurses in 2 hours-workshop about triage protocol according to Iran standard certificate of acute stroke was conducted by a neurologist. The 231 records was assessed two months after education. Results: The knowledge of triage nurses about Iran standard certificate of management of acute stroke treatment was assessed low in this study 60% (25 nurses). Mostly wrong answers were about meaning of FAST protocol in stroke patients 85% (35 nurses) and meaning of 724 hospital 73% (30 nurses). Level of triage in stroke patients was in level one and two 64.1% (157 cases) and 35.9% (88 cases) in level three; before education to nurses. After education level of triage was 94.2% (218 cases) in level one and two and 5.6% (13 cases) in level three. Proper triage categorizing of stroke patients was improved statistically meaningful after education (P=0.00). Before education stroke code was activated in 20% (49 cases) by nurses. After education stroke code was activated in 38.5% (89 cases) by nurses. The increasing rate of stroke code activation by nurses was statistically meaningful after education (P=0.00). Mean time of first visit of patient by physician in emergency ward was 16.47 minutes (SD=13.52) before education; but after education the mean time was decreased to 7.64 minutes (SD=6.55).