What is the process for obtaining NIH stroke certification?

Answer from top 1 papers

The National Institutes of Health Stroke Scale (NIHSS) is widely used for assessing stroke severity and has become the gold standard in clinical trials and regulatory compliance (). To ensure reliable use of the NIHSS, a certification process was developed as part of the NINDS r-tPA for Acute Stroke Trial (). This certification involves training and testing using educational videotapes, which has proven to be an effective, inexpensive, and practical approach for enhancing expertise among physicians in multicenter studies ().
Interestingly, while the NIHSS certification process aims to improve reliability, some studies have found lower than anticipated inter-rater reliability, particularly when used via telemedicine ((Mcloughlin et al., 2022)). Factors such as professional group, frequency of use, and specialization may influence reliability, with consultants tending to score better than nurses ((Mcloughlin et al., 2022)). This highlights the importance of ongoing training and recertification.
In conclusion, the NIHSS certification process plays a crucial role in standardizing stroke assessment across healthcare professionals. Over 500,000 healthcare professionals have been certified to administer the NIHSS using a web-based platform (). While the certification process has been successful in improving reliability overall, continued efforts are needed to address potential variations in scoring and ensure consistent application of the scale across different settings and modes of administration.

Source Papers

406
10.12968/bjnn.2022.18.sup5.s3

Reliability of the National Institutes of Health Stroke Scale

Oct 01, 2022
British Journal of Neuroscience Nursing
Alison Mcloughlin + 2 more +2

Background: The National Institutes of Health Stroke Scale (NIHSS) is widely used to measure stroke deficits and is deemed to be reliable when used by a range of professionals. Aims: This study aimed to establish the inter-rater reliability of the NIHSS when completed via telemedicine. Secondary aims were to explore if professional group, length of time since training and/or re-certification, frequency of use and reason for using the NIHSS influenced the inter-rater reliability. Methods: A total of 30 video clips, the equivalent of two whole patient assessments for each of the 15 NIHSS items, were analysed by a range of NIHSS-certified clinical participants. Of these, 10 were nurses and five were consultants. Kappa statistics were used to calculate the inter-rater reliability for each item, with additional data on the range of agreement of items. Data across group characteristics were compared to test hypotheses about factors that could impact reliability. Findings: Overall, the inter-rater reliability was found to be lower than anticipated, and there was a wide variation in ratings. Consultants tended to score better than nurses, and, counter-intuitively, stroke specialist staff and those who used the NIHSS more frequently tended to have poorer reliability than their counterparts. Total agreement on score was only achieved in five out of the 30 video clips (16.6%), with agreement better at either end of the scoring range (i.e. no deficit or worst deficit). These findings indicate that reliability of the NIHSS may be lower than anticipated. Conclusion: Further research is needed to better understand the poor reliability of the NIHSS, as this has implications for care decisions and patient outcomes.