NIHSS - NIH Stroke Scale

The National Institutes of Health Stroke Scale (NIHSS) certification, developed by the American Stroke Association (ASA), American Academy of Neurology (AAN), and National Institute of Neurological Disorders and Stroke (NINDS), is available through the American Heart Association (AHA). This online training program helps nurses, emergency physicians, neurologists, clinical researchers, medical students, and other healthcare professionals learn or review how to administer the NIH Stroke Scale for the assessment of acute stroke.

NIH Stroke Scale certification course modules include six groups (Groups A through F) and each group includes six patients. Students usually begin with Test Group A and work their way through the groups on an interval of 6 to 12 months. Evaluating one complete group is sufficient for a course completion certificate, then NIHSS certified providers use the additional groups to renew their certificate. Each test group is equivalent in size and scope, but the scenarios are different in each group to assure mastery of the stroke scale over time.

Overall, the program consists of instruction, demonstration, and certification. The objectives of the NIHSS certification course include teaching learners how to identify and assess neurological deficits in stroke patients. The course also teaches them to understand the measurement scale for quantifying these deficits and consistently apply appropriate scores to these deficits. They also learn to use the scale to assess changes in these neurological deficits over time.

• Completion Time: It’s estimated that each course module will take 2 hours to complete.

• Cost: Free for all American Heart Association members and $10 for all other registrants.

Each time a healthcare provider completes and passes a test group, they can automatically view and print their course completion certificate and continuing education (CE) or continuing medical education (CME) certificate, if applicable.

National Institutes of Health Stroke Scale certification is completed online. Healthcare professionals must rate a test group of three patients applying the stroke scale in case-based scenarios. They must not rate more than six items in a test group incorrectly or they will fail the course. Healthcare professionals who don’t pass the test at the end of a module can go back and review the training video, then retake the exam. Upon passing the module, they must provide feedback used for evaluation purposes before they can claim their CME/CE credits.

Test Completion Certificates document compliance of NIHSS certification. These certificates are valid for up to one year. The initial test group (Group A) is valid for one year but renewable at 6 months. The remaining test groups are valid for 24 months but renewable after 12 months since most healthcare facilities require annual certifications. Therefore, after passing Group A, providers should wait 6 months before taking Group B. After passing Group B, they should wait 12 months before taking Group C, then take each additional module in 12-month intervals.

The AHA is accredited by the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE), and American Nurses Credentialing Center (ANCC) to provide continuing education for certain healthcare providers. As such, physicians and physician assistants can take up to 2 AMA PRA Category 1 credits for completing a test group and RNs can claim up to 2 CE hours.

As healthcare providers complete and pass a test group, they can automatically view and print their course completion certificate and continuing education (CE) or continuing medical education (CME) certificate. They can only claim CME/CE certificates once per test group (A through F), but they can print their certificates as many times as necessary. The date on the certificate indicates when the certificate was originally claimed.

The American Heart Association offers an additional stroke-related course that covers Stroke Care During the COVID-19 Pandemic, which takes about half an hour to complete. It also recommends further reading for NIHSS certification participants that includes:

• Utility of the NIH Stroke Scale as a Predictor of Hospital Disposition

• A Modified National Institutes of Health Stroke Scale for Use in Stroke Clinical Trials

RNs who specialize in caring for stroke patients may want to consider Stroke Certified Registered Nurse (SCRN) credentials through the American Board of Neuroscience Nursing. SCRN certification is designed to promote excellence in stroke patient care among stroke nurses, including hyperacute, acute, post-acute, secondary, and preventative care.