Abstract

Introduction/Aims

This project evaluated the effectiveness of targeted stroke re-education in improving nursing staff knowledge and confidence in stroke recognition and documentation in the inpatient setting. The project aims to improve early identification and documentation of suspected stroke symptoms to support time-sensitive diagnostic imaging and treatment, and to evaluate nurses' self-perceived general knowledge of acute stroke assessment and hyperacute stroke management.

Methods

10-20 active nursing staff (ages 22-50+) assigned to Unit 11A were identified at the Loma Linda University Medical Center Cardiac and Medical Progressive floor in May 2026. All voluntary participants completed the nursing demographic survey and the pre-intervention Acute Stroke Management Questionnaire (ASMaQ). After completing the surveys, participants attended a 30-minute PowerPoint education session reinforcing the established BEFAST-G assessment tool in the hyperacute stroke (HAS) pathway. The participants completed the ASMaQ, and the CDC Recommended Training Effectiveness Questions for Post-Course Evaluations after training. After four weeks of training, the participants completed the CDC Recommended Questions for Delayed Evaluation

Results

Eleven nursing staff participated in the targeted stroke education session. The project effectively implemented a standardized BEFAST-G re-education program in a non-stroke acute care unit and reinforced stroke recognition, documentation, and timely escalation practices. Findings supported the need for ongoing tailored stroke education and identified an opportunity to develop unit-based stroke champions to support sustainability. Pre-, post-, and delayed evaluation data provided a structure to assess changes in nursing staff’s perceived knowledge and confidence, as well as the educational intervention’s effectiveness.

Impact and Significance

A structured and tailored stroke education program helped increase the perceived knowledge and confidence of the nursing staff, and the impact and significance of the session could be distributed to staff that did not directly participate in the project. The influence on patient outcomes and nursing practice could be measured in future quality initiatives.

Recommendations

A structured, tailored stroke education program increased nursing staff's perceived knowledge and confidence, and the session's impact and significance could be shared with staff who did not directly participate in the project. Future quality initiatives could measure the influence on patient outcomes and nursing practice. Integrative education tailored to adult learners should be considered to foster independence and promote perceived improvements in knowledge and confidence in caring for patients who develop focal neurological symptoms in the acute care setting. Recommendations suggest that stroke education should be an ongoing procedure to help improve assessment, documentation practices, and timely hyperacute stroke activation when indicated.

LLU Discipline

Nursing

Department

Nursing

School

School of Nursing

First Advisor

Robin Dudley Pueschel

Second Advisor

Salem Dehom

Degree Name

Doctor of Nursing Practice (DNP)

Year Degree Awarded

2026

Date (Title Page)

Summer 2026

Language

English

Type

Doctoral Project

Page Count

112 p., 1 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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