Performance Measurement Network

Question: Time NIHSS performed

Our neurologists include the NIHSS in their dictated H&P and consult report. Could I use the time the H&P or consult was dictated as the time the NIHSS was performed?

Answer:

Generally, the initial NIHSS is done by the ED nurse or stroke coordinator or by teleneurology, and documented in ED. H&P is also an acceptable source; however, to pass the measure, the NIHSS must be done prior to IV t-PA, IA t-PA, or mechanical reperfusion OR documented within 12 hours for ischemic stroke patients who do not undergo reperfusion therapy. The time on the note may be later than the time the score was performed. If the time on the note is the only time documented, then it may be used.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK-01, Initial NIHSS Score Time,
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