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The mobile stroke unit nurse : An international exploration of their scope of practice, education, and training
Coote, Skye Mackey, Elizabeth Alexandrov, Anne W. Cadilhac, Dominique A. Alexandrov, Andrei V. Easton, Damien Zhao, Henry Langenberg, Francesca Bivard, Andrew Stephenson, Michael
Coote, Skye
Mackey, Elizabeth
Alexandrov, Anne W.
Cadilhac, Dominique A.
Alexandrov, Andrei V.
Easton, Damien
Zhao, Henry
Langenberg, Francesca
Bivard, Andrew
Stephenson, Michael
Abstract
BACKGROUND: Mobile stroke units (MSUs) are ambulance-based prehospital stroke care services. Through immediate roadside assessment and onboard brain imaging, MSUs provide faster stroke management with improved patient outcomes. Mobile stroke units have enabled the development of expanded scope of practice for stroke nurses; however, there is limited published evidence about these evolving prehospital acute nursing roles. AIMS: The aim of this study was to explore the expanded scope of practice of nurses working on MSUs by identifying MSUs with onboard nurses; describing the roles and responsibilities, training, and experience of MSU nurses, through a search of the literature; and describing 2 international MSU services incorporating nurses from Memphis, Tennessee, and Melbourne, Australia. METHODS: We searched PubMed, CINAHL, and the Joanna Briggs Institute Evidence-Based Practice database using the terms “mobile stroke unit” and “nurse.” Existing MSUs were identified through the PRE-hospital Stroke Treatment Organization to determine models that involved nurses. We describe 2 MSUs involving nurses: one in Memphis and one in Melbourne, led by 2 of our authors. RESULTS: Ninety articles were found describing 15 MSUs; however, staffing details were lacking, and it is unknown how many employ nurses. Nine articles described the role of the nurse, but role specifics, training, and expertise were largely undocumented. The MSU in Memphis, the only unit to be staffed exclusively by onboard nurse practitioners, is supported by a neurologist who consults via telephone. The Melbourne MSU plans to trial a nurse-led telemedicine model in the near future. CONCLUSION: We lack information on how many MSUs employ nurses, and the nurses' scope of practice, training, and expertise. Expert stroke nurse practitioners can safely perform many of the tasks undertaken by the onboard neurologist, making a nurse-led telemedicine model an effective and potentially cost-effective model that should be considered for all MSUs.
Keywords
ambulance, mobile stroke unit, nurse practitioners, nurse-led, nursing, prehospital, stroke
Date
2022
Type
Journal article
Journal
Journal of Neuroscience Nursing
Book
Volume
54
Issue
2
Page Range
61-67
Article Number
ACU Department
Nursing Research Institute
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled