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Health Stroke Scale:
Stroke is a leading cause of death, hospitalization, disability and health care expenditure in U.S. (Fonarow G. et al., 2012). Stroke is a medical condition requires emergency care and it may cause long lasting brain damage, long-term disability, or even death (National Heart Lung and Blood Institute, 2011). Nurses who usually have the first contact with patient should be ready to assess patients using accurate tool to identify patients with stroke and provide the appropriate care as soon as possible to prevent the complications. In addition, it is the nurse responsibility to observe the patient during the acute phase of stroke. As mentioned in kumar A. et al., (2012), predict the outcome after stroke is important for discussing prognosis with patients or their healthcare providers. There is a strong relation between baseline stroke severity and outcome after stroke. Therefore, a tool for measuring the baseline severity of neurological impairments is important. The use of such a tool may improve the medical documentation and communication between healthcare providers.
There are several scales that used to assess consciousness level in stroke patients but the most recommended one is the National Institutes of Health stroke scale (NIHSS). The validity and reliability of this scale is very strong. Since 1996, NIHSS has become the standard of care for assessing neurological status of ischemic stroke in US stroke centers, and the Brain Attack Coalition guidelines, the American Stroke Association (ASA) guidelines and the ASA nursing scientific statement for care of patients with acute stroke supported the use of this scale for care of patients with acute ischemic stroke (Brandon R, et. al. 2012).
A rural town in an established agricultural area with no prospects for extensive development is located along a river that is used as the source of water supply for the community.
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