NIHSS Certification Guide for Nurses & Allied Clinicians

If you provide care to patients that had a stroke, whether you are assigned to the ER, ICU, Med-Surg, neuro units, or imaging, you’ve probably heard about NIHSS certification. It’s a must-have clinical tool for nurses and clinicians working in hospitals that treat acute strokes or hold stroke center designation.

In this guide, you’ll learn what NIHSS certification is, who needs it, how to get certified online, how much it costs,and why it’s a smart move for travel nurses and allied health pros looking to expand their expertise and learn new skills.

What is NIHSS Certification?

NIHSS certification refers to training in the NIH Stroke Scale, a standardized assessment tool used by healthcare professionals to evaluate the severity of a stroke. The NIHSS certification is considered a gold standard, evidence-based tool for acute stroke assessment. It was developed by the National Institutes of Health and has been validated in multiple studies as a reliable and standardized way to measure stroke severity.

• The tool shows good inter-rater reliability (different clinicians tend to score patients similarly).

• It’s also been shown to predict patient outcomes, such as likelihood of recovery, disability, or need for higher-level care.

Because of this evidence, it’s a core component of stroke guidelines from organizations like the American Heart Association/American Stroke Association.

Developed by the National Institutes of Health (NIH), this scale assigns a numeric score based on a patient’s neurological assessment. It's used in:

• Emergency stroke triage

• Code Stroke protocols

• Neurological monitoring in ICU, Medical Surgical Telemetry or Stepdown units

• Research and clinical trials

The NIHSS certificate confirms that you are trained to promptly recognize and accurately assess patients using this tool, an essential component of any stroke-ready hospital.

Who Needs NIHSS Certification?

You may be required to get NIHSS certified if you work in or alongside stroke care teams or on a unit caring for neurological patients.

Common roles that require or recommend NIHSS certification:

Nurses (including travel nurses):

• ER/ED Nurses

• ICU Nurses

• Step down / Progressive Care Nurses

• Neurology and Med-Surg Nurses

• Stroke Program Coordinators

• Travel Nurses in stroke-certified facilities

Allied Clinicians:

• Respiratory Therapists (RTs)

• Physical & Occupational Therapists (Neuro Rehab)

• CT/MRI Technologists

Advanced Providers & Admins:

• NPs and PAs

• Stroke Coordinators or Educators

Hospitals pursuing stroke center disease-specific certification (DSC) often require NIHSS training across multiple departments — not just nurses.

Why NIHSS Certification Matters

• Improves patient outcomes through faster, more accurate stroke triage
• Required by stroke-certified hospitals (Joint Commission, DNV, etc.)
• Standardizes care across emergency, ICU, rehab, and imaging teams
• Boosts job eligibility — many travel contracts now require it
• Adds value to your résumé for roles in neurology or emergency care

Travel nurses with NIHSS certification are more competitive for contracts in stroke-designated hospitals and stroke telehealth programs.

How to Get NIHSS Certified (Step-by-Step Guide)

The best part? NIHSS certification is completely free and fully online.

Step 1: Visit the NIHSS Training Portal

Visit online: https://www.apexinnovations.com/

Step 2: Create an Account

Register as a new user. Use your email and set up a password for easy login access.

Step 3: Start your Curriculum

Your curriculum will be set to take the NIHSS Stroke Scale Course “I - NIH Stroke Scale Training & Certification” 

Step 4: Take the Certification Test

• Format: Multiple choice, video-based scenarios

• Passing Score: 93% or higher

• Time: ~60-90 minutes

• Retakes: Unlimited until passed

Step 5: Download Your Certificate

Save and upload to your credentialing file or agency profile (like Nomad’s!).

NIHSS Certification Cost & Renewal

NIHSS certification is completely free, takes about 2–3 hours to complete, is valid for 1–2 years depending on the group, and requires retaking the full exam for renewal.

Plan for ~2-3 hours of uninterrupted time to complete the training and test.

How to Renew NIHSS Certification

NIHSS must be renewed every 1-2 years, depending on which test Group you initially chose. Here's how to do it:

1. Log back into the Apex Innovations portal.

2. Complete the next version of the certification test.

3. Download your updated certificate.

4. Update it in your employer or agency profile.

How NIHSS Is Used in Clinical Practice

Hospitals use NIHSS to guide treatment decisions in acute stroke situations, including:

• Emergency Room triage: Establish stroke severity and eligibility for tPA or thrombectomy

• ICU & Neuro floor: Monitor progression or improvement

• Radiology/CT/MRI: Support image interpretation in “Code Stroke” scenarios

• Rehabilitation units: Track neurological recovery

• Stroke registries/clinical trials: Standardized documentation and research

NIHSS is a universal language in stroke care, from triage to rehab.

NIHSS vs. Other Clinical Certifications

Career Benefits of NIHSS Certification

• Access more travel contracts (especially in stroke-designated hospitals)

• Stand out for high-paying jobs in ER, ICU, neuro, or telemedicine

• Meet credentialing requirements faster

• Earn more trust in stroke emergencies from peers and physicians

• Strengthen your résumé with standardized neuro assessment training