Authors (including presenting author) :
Yuen WT(1), Kwok Y(1), Cheung YH(1), Lam HY(1), Lam CM(1)
Affiliation :
(1) Ortho Rehab Ward 3L,Department of Medicine, Haven of Hope Hospital
Keyword 1: :
stroke management
Keyword 2: :
early detection
Keyword 3: :
neurological assessment
Keyword 4: :
standardized documentation
Keyword 5: :
nursing knowledge
Keyword 6: :
clinical practice advancement
Introduction :
Patients undergoing hip and knee replacement surgeries are at increased risk of perioperative stroke. Pang (2024) reports a strong association between major orthopedic procedures and stroke incidence. In Ward 3L at Haven of Hope Hospital, clinical observations identified gaps in nursing staff knowledge related to stroke recognition and emergency management. Timely neurological assessment, prompt activation of stroke protocols, and effective communication are essential to improving patient outcomes. Evidence suggests that ongoing education enhances healthcare professionals’ ability to identify high-risk patients and recognize early stroke symptoms, facilitating timely intervention and improved survival (Rababah, Al-Hammouri, & AlNsour, 2021).
Objectives :
1.Enhance nursing awareness of perioperative stroke risk in postoperative orthopedic patients. 2.Improve neurological assessment skills and timely activation of the KEC stroke protocol. 3.Reduce missed in-patient strokes through standardized assessment and accurate documentation to support effective communication.
Methodology :
A multifaceted nursing education and practice enhancement program was implemented from 25 March to 25 April 2025, involving 18 nursing staff from Ward 3L. Interventions included dissemination of a stroke assessment training video developed by the KEC neurology nursing team, paired skills demonstration sessions with real‑time feedback, and provision of a quick reference cue card to support rapid stroke assessment. A practice‑based stroke risk flagging approach was introduced to facilitate routine identification of high‑risk patients. Standardized baseline neurological assessment and documentation were implemented using structured templates integrated into the electronic documentation (eDocumentation) system and accessed via QR codes. The program emphasized timely neurological reassessment, accurate documentation, and prompt escalation according to established stroke protocols.
Result & Outcome :
Pre and post training assessments demonstrated improved nursing knowledge of stroke risk factors, warning signs, Glasgow Coma Scale 2014 usage, and stroke protocol activation. Evaluation surveys indicated that 100% of participants reported improved neurological assessment skills. The cue card was rated as practical by all participants, with 78% strongly agreeing and 22% agreeing. All staff reported that standardized baseline neurological documentation facilitated earlier recognition of neurological changes. A documentation audit conducted six months post‑implementation demonstrated 100% compliance in baseline neurological documentation for high‑risk patients, indicating sustained improvement in clinical practice and governance.
