Evidence-Based Initial Nursing Care for Acute Stroke in Emergency Settings: A Scoping Review

Objective: To identify and map evidence-based practices and international guidelines related to initial nursing interventions in the emergency management of acute stroke. Method: This scoping review followed the Joanna Briggs Institute (JBI) framework and the PRISMA-ScR checklist. A comprehensive literature search was conducted in PubMed, CINAHL, Scopus, the WHO guideline repository, and Google Scholar. Studies and guidelines published between 2015 and 2024 were included. Data extraction focused on study characteristics, nursing roles, and intervention components. Results were analyzed descriptively and thematically. Results: Fourteen studies and guidelines met the inclusion criteria. Most originated from high-income countries, with the USA and China being the most represented. The included documents comprised experimental studies, guidelines, reviews, and implementation evaluations. Key nursing roles included stroke triage, NIHSS assessment, vital sign monitoring, dysphagia screening, thrombolysis preparation, and coordination with stroke teams. Structured protocols, such as FeSS bundles, and simulation-based training were reported to enhance care delivery and patient outcomes. However, gaps remain in the explicit articulation of nursing responsibilities in many guidelines. Conclusion: Nurses play a critical role in the early management of acute stroke in emergency settings. Standardized, context-adapted nursing protocols and targeted training are needed to optimize stroke outcomes and ensure effective integration of nursing practices into emergency stroke pathways.