Arizona State University

A collaborative online neurovascular advanced practice nurse (APN) post-graduate fellowship program by the ASU College of Nursing & Healthcare Innovation with the University of Alabama-Birmingham’s (UAB) School of Nursing and Comprehensive Stroke Center is off to a fast start. The continuing education program is intended to prepare more APNs to help improve acute stroke treatment.
Stroke is the No. 1 cause of adult disability in the United States.

The Health Resources and Services Administration funds NET SMART (Advanced Practice Nurse Education & Training in Stroke Management & Acute Reperfusion Therapies), a three-year continuing education project to prepare APNs to treat stroke victims.

The NET SMART continuing education program started in January with the first 25 APN fellows enrolled within 45 days of program announcement, says Anne Wojner-Alexandrov, the principal investigator and director of the project. The program is currently enrolling the next cohort.

NET SMART provides Internet-based continuing education, supported by an on-site, two-week clinical preceptorship and validation period at the UAB Hospital. The UAB clinical experience carrys one of the highest rates for provision of intravenous thrombolysis and intra-arterial rescue therapies, and it provides APN fellows with a high-volume, fast-paced environment and a complex neurovascular patient population typical of the U.S. “stroke belt.”

Stroke is the leading cause of permanent disability in adults and the third-leading cause of death in the United States, affecting more than 700,000 Americans each year, while another estimated 300,000 are diagnosed with transient ischemic attack (TIA), a high-risk stroke precursor in emergency situations.

“NET SMART is unique because it combines the strengths of two leading nursing programs with a medical school’s department of neurology that is one of the strongest in the nation,” says Bernadette Melnyk, dean of ASU’s College of Nursing & Healthcare Innovation. “NET SMART also provides participants with on-site validation in the heart of the nation’s ‘stroke belt,’ where there are more cases of stroke and stroke deaths per year than anywhere else in the United States.”

The case for need

Establishment of stoke centers in more than 400 hospitals across the country has made it difficult to obtain expert practitioner staffing. In the United States, there are fewer than 200 fellowship-trained stroke neurologists, and just 10,461 board certified neurologists. To combat personnel shortages, several hospitals and physicians have begun to turn to APNs who can be positioned on the front line of acute stroke care, supported by neurologist phone, telemedicine or teleradiology consultation.

“We believe that NET SMART will be a valuable adjunct to learning that will recruit many advanced practice nurses into key acute stroke leadership roles,” says Ray Watts, chairman of neurology at UAB, in a letter of support for the collaborative project. “Our ongoing commitment to APNs places us in a unique position to offer this program, and it is our desire to see APN value and visibility increase significantly within the health care community and lay public as a result of our efforts.”

Target audience and applicant pool

The NET SMART acute stroke fellowship continuing education program targets clinical nurse specialists and nurse practitioners interested in vascular nursing, as well as masters-prepared stroke program coordinators. The program is designed to prepare participants for clinical leadership roles in the emergency evaluation and treatment of high-risk acute stroke patients. Expertise in the neurosciences is not a requirement for participation for the program.

Enrollees in NET SMART complete Internet-based learning modules, complemented by clinical learning activities and post-tests. Once the modules are completed, participants attend an 80-hour, on-site clinical preceptorship and validation session at the UAB Comprehensive Stroke Center.

Upon satisfactory completion of the program, participants receive a NET SMART acute stroke fellowship certificate from the ASU College of Nursing & Healthcare Innovation.

“The feedback we’ve received on the program from our current fellows has been incredibly positive,” Alexandrov says. “Our fellows have rapidly expanded their knowledge and skills, far beyond that of most APNs providing care to acute stroke patients. It is exciting and rewarding to work with these remarkable new nursing leaders, and I am optimistic that each will make significant contributions that dramatically improve the care of our nation’s acute stroke patients in the coming years.”

For more information, call (480) 727-6262 or visit the Web site www.netsmart-stroke.com.