2. 2 www.heartandstroke.ca/profed Canadian Neurological Scale: Training for Trainers Workshop Implementing the CNS in Your Organization

3. 3 www.heartandstroke.ca/profed Thanks The Heart and Stroke Foundation of Ontario gratefully acknowledges the contribution of Rhonda McNicoll, R.N., BSc.N., CNN(c), Hamilton Health Sciences, in the development of this presentation.

4. 4 www.heartandstroke.ca/profed Implementing the CNS in Your Organization There are several common steps for development of policies, procedures and forms used within organizations: Identifying the need Develop the document and plan the implementation Consult with stakeholders Obtain approval signatures for approval Implement and evaluate It is important that you determine the process within your organization and follow those steps

5. 5 www.heartandstroke.ca/profed Identifying the Need Consult with department/committee in charge of policy and procedure development to identify that you would like to implement the CNS within your organization and determine your next steps Review guidelines for developing policy and procedures in your organization

6. 6 www.heartandstroke.ca/profed Develop the Document & Plan Implementation Form a project working group of stakeholders to discuss development and plan for implementation. Members should be affected by the change and willing to champion the change process. Adapt templates for CNS policy, procedure and record provided in CNS Teaching Package to meet policy, procedure and health records guidelines, and the clinical needs of your organization. Develop an implementation plan for communication, education, implementation and evaluation of the document. Identify potential issues and strategies for resolution.

7. 7 www.heartandstroke.ca/profed Consult with Stakeholders & Obtain Approval Signatures Forward draft procedure and record with necessary documentation to stakeholders and relevant committees asking for review and feedback within specified timeframe Review feedback and revise documents as required Review and confirm final document and approval signatures required with Policy and Procedure Committee Obtain approval signatures Forward form for approval by Policy and Procedure Committee and Health Records Committee

8. 8 www.heartandstroke.ca/profed Implement the Document & Evaluate Involve key educators and champions from units who are implementing the CNS and encourage their attendance at a CNS Training for Trainers Workshop to develop expertise Develop and implement an educational training plan for front line staff to meet the needs of the unit using resources provided in training workshop Suggestions for training modalities: 2 hour workshop (see agenda) plus practice clinically OR Self directed learning package and review video THEN Return demonstration of skills clinically with an preceptor/educator

9. 9 www.heartandstroke.ca/profed Suggested Training Workshop for Front Line Staff 2 hour workshop: 15 minutesWelcome and Meeting Objectives 45 minutesThe Canadian Neurological Scale: What, Why, When and How 15 minutesPractice with a Partner: Review of Scoring Process 45 minutesPatient Assessment Simulations and Wrap up

10. 10 www.heartandstroke.ca/profed Implement the Document & Evaluate cont… Develop a documentation audit form for CNS Tool and/or observation record to ensure guidelines for use are followed and appropriate action is taken when CNS scale decreases during implementation period and ongoing Build in some reliability testing using trained experts such as educators, expert trained staff to ensure reliability of assessment during implementation period and ongoing Consider annual review or demonstration of competency of assessment