Implementing the NIHSSIn Your Organization

January 2008

Implementing the NIHSS in Your Organization There are several common steps for developing

policies, procedures and forms in organizations: Identify the need Develop the document and plan the implementation Consult with stakeholders Obtain signatures for approval Implement and evaluate

It is important to determine the process within your organization and follow those steps.

Identifying the Need

Consult with department/committee in charge of policy and procedure development to identify that you would like to implement the NIHSS within your organization and determine your next steps.

Review guidelines for developing policy and procedures in your organization.

Develop the Document & Plan Implementation Form a project working group of stakeholders to

discuss development and plan for implementation. Members should be willing to champion the change process.

Adapt templates for NIHSS policy, procedure and record provided in NIHSS Workshop Package to meet policy, procedure and health records guidelines, and the clinical needs of your organization.

Develop an implementation plan for communication, education, implementation and evaluation of the document.

Identify potential issues and strategies for resolution.

Consult with Stakeholders & Obtain Approval Signatures Forward draft procedure and record with

necessary documentation to stakeholders and relevant committees asking for review and feedback within specified timeframe.

Review feedback and revise documents as required.

Review and confirm final document and approval signatures required with Policy and Procedure Committee.

Obtain approval signatures. Forward form for approval by Policy and Procedure

Committee and Health Records Committee.

Implement the Document & Evaluate Involve key educators and champions from

units who are implementing the NIHSS and encourage their attendance at a NIHSS Workshop to develop expertise.

Develop and implement an educational training plan for front line staff to meet the needs of the unit using resources provided in training workshop.

Implement, cont…

Suggestions for training modalities: 3 hour workshop (see agenda) plus practice

clinically OR

Self directed learning via online certification THEN

Return demonstration of skills clinically with an preceptor/educator

Suggested Training Workshop for Front Line Staff

3 hour workshop: 15 minutes Welcome and Meeting Objectives 60 minutes National Institutes of Health Stroke

Scale: Overview and Demonstrations

60 minutes Practice with Partner 45 minutes Patient Assessment Simulations

Wrap Up

Implement cont… Develop a documentation audit form for NIHSS Tool

and/or observation record to ensure guidelines for use are followed and appropriate action is taken when NIHSS decreases during implementation period and ongoing.

Build in some reliability testing using trained experts such as educators and staff to ensure reliability of assessment during implementation period and ongoing.

Consider annual review or demonstration of competency.