What influences nurses to undertake accurate assessment of the Glasgow Coma Scale?

Abstract

Aim-To identify influencing factors that have an impact on nurses' performance of the Glasgow Coma Scale (GCS) Objectives-To appraise contemporary primary research investigating nurses' performance of the GCS, to identify concerning factors that have an impact on nurses' performance of the GCS, to facilitate a more accurate and consistent use of the tool, and to formulate recommendations for optimising its reliability. Background-The GCS has been routinely used for over 40 years as an objective neurological tool to assess patient's level of consciousness following head injury, however, users have found certain aspects of the GCS confusing despite the accuracy of performance being of utmost importance for patient's safety. Method-Six databases were searched (2006-2016) to review studies that addressed factors influencing nurses' performance of the GCS. Findings-Seven studies were identified and critically reviewed. Knowledge and experience were found to be the main factors, issues with accuracy and application of painful stimuli have been highlighted. Scores between healthcare providers were inaccurate. Recommendations-Educational interventions should be implemented and the Neuroscience Nurse Benchmarking Group (NNBG) guidelines more widely available. To ensure consistency, nurses' taking handover should observe how the GCS was obtained and documented. Conclusion-This review has found that knowledge and experience are the most significant factors influencing nurses' performance of the GCS. Inconsistencies were found regarding the application of painful stimuli and accuracy of documentation.

Knowledge and Practice about Glasgow Coma Scale Assessment among Nurses Working in Adult Intensive Care Units of Federal Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study

“…As a result, they should be well-versed in the GCS assessment and confident in their abilities ( 19 , 20 ). However, several studies assessing nurses' and other clinicians' knowledge of the GCS have revealed a lack of understanding and improper application of this vital instrument ( 11 , 21 ).…”