School of Nursing


Doctor of Nursing Practice (DNP)


Vickie Moore


stroke symptoms, rural hospital, VAN assessment, nurse education




Thousands of persons in the United States yearly suffer acute large vessel occlusion stroke (LVO). Caring for these individuals with strokes and the ensuing issues increases healthcare dollars. In underserved, rural communities, there is a dire need for improved methods to access care for these individuals. A 3-month evidence-based practice (EBP) project was conducted in a small rural town in Virginia with one of the state’s highest rates of acute stroke. Nurses in the rural hospital voluntarily participated in an educational program on recognizing acute stroke and utilizing the Vision, Aphasia, Neglect (VAN) assessment tool. The participants (N-15) were asked to complete pre- and post-questionnaires on stroke and VAN knowledge. In addition, the nurses completed a Likert confidence scale and a subjective evaluation at the end of the 12 weeks. Nurses were given a badge card and a smartphone application to help remind them of the VAN assessment. Following the educational program, the participants had a 7.5% increase in knowledge. After the 3-month intervention, the overall knowledge retention was only 1.7%, thus a 5.8 percent decrease in knowledge retention. According to the Likert scale and subjective data, the nurse’s comfort level with recognizing patients who could be suffering from an acute LVO stroke increased. The data confirms that educating the nursing staff is crucial in recognizing new acute stroke symptoms in their patient population. VAN assessment tools, badge cards, and smartphone applications are effective interventions that need frequent re-education and reinforcement of learning concepts to increase the recognition of acute LVO stroke symptoms in the patient population.

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