Describe the impact of a new stroke nurse training program at the University Teaching Hospital in Lusaka, Zambia.

Stroke units, which rely heavily on specialized nursing care, are the global standard of stroke care and are associated with improved outcomes.  However, they are largely absent in resource-limited settings.

Prior to opening Zambia’s first-ever stroke unit in October 2023, two one-week stroke nurse training workshops were conducted in September 2023. These utilized training materials adapted from the Wessex Ghana Stroke Partnership, which were co-designed by multidisciplinary team members in Ghana and the UK. Individual semi-structured interviews were conducted with Zambian nurses who had completed training; these were analyzed thematically.

All nurses interviewed (n=18 of 30 trained) rated their training very positively, reporting feeling empowered with new knowledge and skills and developing improved communication with patients, caregivers, and stroke doctors. Specifically, nurses reported their clinical practice had changed from skill-building in the following areas: (1) turning and repositioning patients more frequently; (2) aspiration prevention through implementation of formal nurse-led swallow screenings; (3) increased mobilization of patients through implementation of nurse-led mobility assessments and nurse-/caregiver-led exercises; and (4) improved incontinence management by reducing catheter use and more frequent diaper changes. Despite increased workload, nurses felt motivated and proud to pioneer a new standard of care for stroke patients in Zambia. Nurses suggested implementing monthly continuing medical education, periodic performance evaluations, Stroke Nurse of the Month incentives, and nurse exchange visits to established stroke centers in the future.