PREP2 Advanced: NIHSS

 

Purpose
For patients with a SAFE score of less than 5 on Day 3, a NIHSS score that is obtained on Day 3 is required. The purpose of this section is to provide information to allow you to gain certification to use the NIHSS.

Overview
The National Institutes of Health Stroke Scale (NIHSS) is a 15 item neurological scale used to evaluate neurological deficits after stroke. It includes assessments on levels of consciousness, vision, motor strength, ataxia, speech, language and sensory loss. Each item is scored, with a score of 0 typically indicating normal function. Item scores are summed for a total score, with a maximum score possible of 42. Higher total NIHSS scores indicate greater stroke severity. Assessment takes less than 10 minutes to complete by a trained assessor.

Certification
We recommend that staff that need to obtain NIHSS scores for PREP2 are certified in using this scale.

The NIH Stroke Scale International (NIHSS) – English Program is an educational resource that enables annual certification for the NIHSS for healthcare professionals, free of charge. 

The ‘Program’ includes:

• Self-paced training to gain confidence in using the NIHSS to accurately identify, assess and score neurological deficits in stroke patients
• Testing to provide certification in using the NIHSS for 1 year.

 

Frequently asked questions

When is the best time to get the NIHSS score?
If the patient’s SAFE score is less than 5 on day 3, get their NIHSS score straight away, and then organise the TMS test. This way, if they turn out to be MEP- you already have the NIHSS score from day 3, which is the best time to obtain it. In the case of a 5 day service, if a Day 3 NIHSS score is due on Saturday, then obtain the score on Friday. If a Day 3 NIHSS score is due on Sunday, then obtain the NIHSS score on Monday.