Effectiveness of evidence-based nursing on functional outcomes in patients with ischemic stroke: A retrospective cohort study

This study aimed to assess the real-world effectiveness of evidence-based nursing (EBN) on functional recovery in patients with acute ischemic stroke. A retrospective cohort study included 100 patients with first-ever acute ischemic stroke admitted from January 2022 to December 2024. Patients were divided into the EBN group (n = 52) and the usual care (UC) group (n = 48). The primary outcome was the rate of functional independence (modified Rankin Scale ≤ 2) at 90 days. Secondary outcomes included mean modified Rankin Scale scores, National Institutes of Health Stroke Scale improvement, Fugl-Meyer Assessment for upper and lower extremities, stroke-specific quality of life, Barthel Index, functional independence measure, anxiety and depression scores (self-rating anxiety scale, self-rating depression scale), patient satisfaction, length of hospital stay, and in-hospital complications. At 90 days, patients in the EBN group showed a significantly higher rate of functional independence compared to the UC group (67.31% vs 41.67%, P = .001). Beyond functional outcomes, the EBN group demonstrated greater National Institutes of Health Stroke Scale improvement, higher Fugl-Meyer assessment for upper and lower extremities, stroke-specific quality of life, Barthel Index, and functional independence measure scores (all P < .001). Emotional well-being also improved, with lower anxiety (self-rating anxiety scale) and depression (self-rating depression scale) scores, alongside higher patient satisfaction (P < .001). Importantly, the incidence of hospital-acquired pneumonia was significantly reduced (9.62% vs 25.00%, P = .041), while deep vein thrombosis and pressure ulcers showed downward trends. Under comparable baseline conditions, a systematic EBN approach significantly improved 90-day functional independence, neurological and motor recovery, quality of life, and emotional status, while also reducing hospital-acquired complications such as pneumonia. These findings support the routine implementation of EBN in stroke centers and warrant further validation in multicenter prospective studies.