Date of Award

Fall 12-22-2018

Degree Type

Final Project

Degree Name

DNP Doctor of Nursing Practice




Mary Ellen Roberts, DNP

Committee Member

Kristi Stinson, PhD

Committee Member

Erica Frangione-Edfort, DNP


More than 795,000 American adults have a stroke annually. About 610,000 are first or new strokes. Almost 140,000 Americans of all ages die of a stroke every year (Centers for Disease Control and Prevention [CDC], 2017). Stroke requires emergent treatment and an exact clinical order pathway to ensure better patient outcomes and compliance with the standards of care defined by regulatory bodies such as the Joint Commission (TJC) and the Centers for Medicare and Medicaid Services (CMS). While stroke management teams often include an Advanced Practice Nurse (APN), there is a lack of a standardized protocol across New Jersey (NJ) and ambiguity about the role of APNs managing stroke. This quality improvement educational initiative, Stroke Clinical Order Pathways Education (SCOPE) for APNs, was conducted for APNs in NJ to emphasize the importance of the stroke clinical pathway order sets (Appendix A) to improve quality of care for stroke patients and to clearly define the role of APNs.

This Doctor of Nursing (DNP) educational initiative utilized the American Heart Association national guidelines for stroke management and current CMS and TJC criteria for the stroke core measures (Appendix B) quality reporting and combined these strategies to create an evidence-based stroke education initiative for APNs. Between November 2017 and February 2018, the SCOPE for APNs was presented at four sites in northern NJ. The participants attended a one-hour educational session that included a pre-test and post-test (Appendix C), and program evaluation (Appendix D). In total, 28 APNs and 27 RNs attended these sessions.