The NIHSS is a 15-item neurologic examination stroke scale used to
evaluate the effect of acute cerebral infarction on the levels of consciousness, language, neglect, visual-
field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss.
What is the purpose of the NIH stroke scale?
A useful tool in quantifying neurologic impairment is the National Institutes of Health Stroke Scale (NIHSS) (see Table 2, below). The NIHSS
enables the healthcare provider to rapidly determine the severity and possible location of the stroke
.
What is a good NIH stroke scale score?
As a general rule, a
score over 16 predicts
a strong probability of patient death, while a score of 6 or lower indicates a strong possibility for a good recovery. Each 1-point increase on the scale lowers the possibility of a positive outcome for the patient by 17 percent.
Is the NIH stroke scale accurate?
The sensitivity of the NIHSS to detect improvement compared to physician documentation was
37.9% at 24 hours post
-tPA, 68.9% at discharge, and 80% at follow-up, with a specificity of 100% at each time point.
How often should NIH stroke scale be done?
Although the National Stroke Association recommends certification
every six months
, the average re-certification is one year. Some centers train and test their RNs on the NIHSS as a part of annual stroke nurse competencies.
What is a Level 1 stroke?
A Level 1 stroke alert is
a patient with LKN 0-8 hours prior
, and results in the Vascular Neurology team responding immediately to the emergency department. A Level 2 stroke alert is a patient LKN 8-24 hours prior.
How do you use the NIH stroke scale?
Simultaneously touch patient on both hands, show fingers in both visual fields,
ask patient to describe deficit, left hand
. Most people receive a score 0 after taking the NIH stroke scale. Scores as low as one to four could indicate a mild stroke.
What is a bad NIH score?
The NIH grant application scoring system uses a 9-point rating scale (1 = exceptional;
9 = poor
) in whole numbers (no decimals) for Overall Impact and Criterion scores for all applications.
What does a NIH stroke scale of 14 mean?
Very Severe: >25. Severe: 15 – 24.
Mild to Moderately Severe
: 5 – 14. Mild: 1 – 5.
What is a stroke severity tool?
The NIHSS was originally designed as a research tool to measure baseline data from patients in acute stroke clinical trials.
The scale
is widely used today as a clinical assessment tool to evaluate severity of stroke, to determine appropriate treatment, and to predict patient outcome.
What are the limitations to the NIH stroke scale?
Disadvantages & Limitations
Neither the NIHSS nor the mNIHSS are the ideal stroke scale.
Both fail to accurately or reliably detect patients with posterior circulation findings
. With the removal of the ataxia item, there may be concern that the mNIHSS would be even less able to assess brainstem strokes.
How many patients are on the NIH stroke scale test?
Each Group contains
six (6) patients
. The evaluation of one complete group is considered sufficient for a course completion certificate.
How long is NIH stroke scale certification good for?
Certification with this test group is good for
up to 24 months from successful completion
and or 12 months if specified / required by your organiza- tion. 10. After successful completion of A001-NIH Stroke Scale-Certification A, print out “Certificate of Completion” and submit to the Education Department for credit.
Who performs the NIH stroke scale?
The Joint Commission, as part of its certification program for Primary Stroke Centers, now requires an NIHSS score within 12 hours of admission for all stroke patients; this assessment is to be done by
a certified examiner
. Federal agencies also require outcomes adjusted for baseline stroke severity—using the NIHSS.
What is a Level 4 stroke?
1–4 =
minor stroke
. 5–15 = moderate stroke. 15–20 = moderate/severe stroke. 21–42 = severe stroke.
What are the two major types of stroke?
- Ischemic stroke.
- Hemorrhagic stroke.
- Transient ischemic attack (a warning or “mini-stroke”).
