2019 Volume 41 Issue 5 Pages 362-367
Background and purpose: Neurological evaluation using the National Institutes of Health Stroke Scale (NIHSS) is needed to perform thrombolytic therapy via telestroke. Assistance from medical staff in a spoke hospital is inevitable to allow evaluation of NIHSS score by a board-certified doctor in a hub hospital. To improve skills in providing assistance specific to NIHSS evaluation via telestroke, we developed a training video and examined effects on the time for NIHSS evaluation. Methods: We have assessed NIHSS scores for healthy individuals by remote examination and evaluated the time required for measurements. After the first evaluation, we divided participants into two groups: one trained using video teaching materials (Group VT); and the other trained without those materials (Group non-VT). We then evaluated the time required to assess NIHSS scores again. We compared differences in NIHSS evaluation times and the interaction of video training using repeated-measures analysis of variance (ANOVA). Results: Participants were comprised of eight spoke assessors in Group VT and seven in Group non-VT. NIHSS score measurements were significantly quicker in Group VT (88.5 s) than in Group non-VT (19.3 s). In particular, evaluations of visual fields and ataxia were markedly quicker and total examination time was significantly reduced (p = 0.002, 0.007, 0.004, respectively; ANOVA). The interaction effect of the video training was also significant (p = 0.042, ANOVA). Conclusion: Using video training, material reduced the time required for NIHSS score measurements. Education programs for medical staff in spoke hospitals may be useful to shorten the door-to-needle time in telestroke.
