How do nurses recognize subtle signs of stroke and minimize serious damage in older residents of nursing homes?
Summary This qualitative study aims to explore the perceptions of nurses in nursing homes
about signs of stroke and their experiences with older residents who are at a high risk for stroke.
Data were collected through in-depth interviews with 31 nurses from 11 nursing homes in South
Korea. Data were analyzed concurrently with data collection through inductive content analysis.
The findings consisted of three themes: (1) maximizing experiential knowledge: classifying and
comparing in daily work; (2) minimizing further severe cerebral damage: detecting something
strange; and (3) perceiving barriers to caring for older residents with stroke. The nurses used
their clinical experience and personal history, and maximized their knowledge to identify highrisk
residents and recognize the onset of stroke. Through continuous monitoring, they became
aware of subtle changes in the condition of older residents with an underlying illness. After
timely recognition, prompt transfer to an emergency department was important to minimize
serious damage with evidence-based hyperacute treatment. Nurses highlighted that linking
with family members might be important for them to understand nurses’ actions and accept
emergency situations. However, the nurses perceived limited resources and lack of authority as
barriers to stroke care. Poor knowledge about subtle symptoms was also a substantial barrier
to stroke care. Understanding the nurses’ perceptions may be an initial step toward developing
well-defined clinical protocols of effective stroke care in nursing homes.
© 2015 Australian College of Nursing Ltd. Published by Elsevier Ltd.