Nurses' self‐confidence and attitudes in using the Glasgow Coma Scale: a primary study

Mattar, Ihsan; Liaw, Sok Ying; Chan, Moon Fai

doi:10.1111/nicc.12077

Cited by 15 publications

(23 citation statements)

References 26 publications

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“…To distinguish correlation between head AIS scores (1-6) and GCS (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), an analysis was performed. The correlation coefficient Pearson's r was significant at p < .001, with a weak, inverse relationship of -0.3980.…”

Section: Resultsmentioning

confidence: 99%

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Classification of traumatic brain injury severity using retrospective data

Rogers

Trickey²

2017

JNEP

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Objective: Accurate classification of traumatic brain injury (TBI) severity is essential to brain injury research. TBI heterogeneity complicates classification of the injury; is a significant barrier in the design of therapeutic interventions; and results in retrospective data which is difficult to translate. The objective of this study is to describe the differences in two current tools used in the classification of TBI severity, the Glasgow Coma Scale (GCS) and the head Abbreviated Injury Score (AIS), using retrospective data to compare their performance. Methods: Using correlational and descriptive statistics, this study examined two TBI severity classification methods across a large sample of TBI patients (N = 56,131), who were treated at level I and level II trauma centers in the United States and were included in the 2010 National Sample Program (NSP) of the National Trauma Data Bank (NTDB R ). Results: The study population was 67% male, 67% non-Hispanic white, treated most often in trauma centers in the South (38%), with blunt trauma (93%) and from non-motor vehicle collisions (MVC's) (56%). Observation of the AIS classification system demonstrated that it tends to over-score TBI severity compared to the GCS classification. The methods (GCS & AIS) had a weak, inverse relationship with a correlation coefficient (Pearson's r) of -0.3980, which was significant at p < .001. Conclusions: The current study addressed the difficulties associated with categorizing TBI severity when analyzing retrospective data. Although AIS is commonly used to classify severity in retrospective data when GCS is unavailable, the relationship between the two scales is relatively unknown. Results show that AIS and GCS are more closely related for severely brain injured patients but in cases of mild and moderate injury, AIS is less predictive of GCS. Since they are often used in conjunction in identifying brain injured severity in retrospective data, researchers cannot be certain that the tools are similarly classifying mild, moderate, and severe injuries. This study reinforces the need for additional TBI severity classification methods, such as neuroimaging techniques and biomarkers.

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Section: Resultsmentioning

confidence: 99%

“…[5] The missing GCS score in the clinical setting is often related to the lack of training and nurses' lack of confidence in GCS proficiency. [6] It is imperative to have consistent methods of TBI severity stratification.…”

Section: Introductionmentioning

confidence: 99%

Classification of traumatic brain injury severity using retrospective data

Rogers

Trickey²

2017

JNEP

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“…The overall objective of the study was checked by comparing the means and SD of this study with previous studies (Chan & Matter 2013, Mattar et al 2014) done on the same topic. To test research questions one and two, a correlation coefficient will be computed.…”

Section: Discussionmentioning

confidence: 99%

“…GCS is considered easy to use; however, this character opens it to misinterpretation and misapplication. (Mattar et al, 2014;McLernon, 2014).…”

Section: Introductionmentioning

confidence: 99%

Assessment Of Jordanian Nurses' Knowledge To Perform Glasgow Coma Scale

Al-Quraan

AbuRuz

2016

ESJ

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The most important assessment of neurological examination in the clinical setting is assessing level of consciousness. The first neurological tool used to assess patients' level of consciousness was the Glasgow Coma Scale. It is considered as the most common less subjective gold standard coma assessment tool. The purpose of this study was to assess Jordanian nurses' knowledge about Glasgow Coma Scale. A non-experimental, descriptive cross-sectional correlational design was performed in four (3 private hospitals and 1 governmental) hospitals in Amman-Jordan. A self-reported questionnaire was answered by all (ICU, CCU, ER, and Telemetry) nurses who accepted to participate in the study. A total of 200 questionnaires were distributed to the participants with 90% response rate ending with 180 questionnaires in the final analysis. More than half of the sample (56.7%) was males. The participants were young nurses with mean age of 26.3±8 years. The total mean score for the whole sample was 7.38 ± 1.96. There was no relationship between experience, level of education, and training course and knowledge level. Nurses working in accredited hospitals and governmental hospitals recorded more level of knowledge than other hospitals. Emergency Room nurses recorded less level of knowledge than other area of practice. In conclusion, knowledge about Glasgow Coma Scale is a global problem. Jordanian nurses, as other nurses, have inadequate knowledge to perform Glasgow Coma Scale assessment. It is vital and necessary to include educational programs about Glasgow Coma Scale for nurses in all areas of practice and in the curricula of nursing colleges.

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“…Although with time and experience nurses' knowledge improves (Mattar et al, ; Santos, Vancini‐Campanharo, Lopes, Okuno, & Batista, ; Reith et al, ), knowledge and skills obtained from education and experience in the GCS are reported to enhance accuracy and ability to use the GCS tool (Ellis & Cavanagh, ; Hansen, Norris, & Sceriha, ; Heron et al, ; Mattar, Liaw, & Chan, ). Additionally, with time, nurses attained more self‐confidence in using the GCS (Chan, Mattar, & Taylor, ; Mattar, Liaw, & Chan, ), and a more positive attitude was associated with increased self‐confidence (Shoqirat, ). For nurses working in the field of neurosciences, evidence suggests that their knowledge of the GCS is inadequate (Jaddoua, Mohammed, & Abbas, ) and that nurses lack confidence in its use (Ehwarieme & Anarado, ).…”

Section: Literature Review/backgroundmentioning

confidence: 99%

Nurses' understanding and experience of applying painful stimuli when assessing components of the Glasgow Coma Scale

Cook

Braine

Trout

2019

Journal of Clinical Nursing

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Aims and objectives To evaluate nurses' application, understanding and experience of applying painful stimuli when assessing components of the Glasgow Coma Scale. Background The Glasgow Coma Scale has been subjected to much scrutiny and debate since its publication in 1974. However, criticism, confusion and misunderstandings in relation to the use of painful stimuli and its application remain. An absence of evidence‐informed guidance on the use and duration of application of painful stimuli remains, with the potential to negatively impact on decision‐making, delay responsiveness to neurological deterioration and result in adverse incidents. Design and Methods This international study used an online self‐reported survey design to ascertain neuroscience nurses' perceptions and experiences around the application of painful stimuli as part of a GCS assessment (n = 273). The STROBE checklist was used. Results Data revealed varied practices and a sense of confusion from participants. Anatomical sites for the assessment of pain varied, but most respondents identified the trapezius grip/pinch in assessing eye‐opening and motor responses. Most respondents identified they assess eye‐opening and motor responses together and apply pain for <6 s to elicit a response. Witnessed complications secondary to applying a painful stimulus were varied and of concern. Conclusion Neuroscience nurses in this study clearly required evidence‐informed guidelines to underpin practice both in applying painful stimuli and in managing the experience of the person in their care and the family response. A standardised approach to education is necessary to ensure greater interrater reliability of assessment not only within nursing but across professions. Relevance to practice Results of this study illustrate inconsistency and confusion when using the Glasgow Coma Scale in practice; this has the potential to compromise care. Clarity around the issues highlighted is necessary. Moreover, these results can inform future guidelines and education required for supporting nurses in practice.

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Nurses' self‐confidence and attitudes in using the Glasgow Coma Scale: a primary study

Abstract: Mentoring and educational interventions are suggested in order to reduce safety risks resulting from lower proficiency in using the GCS.

Cited by 15 publications

References 26 publications

Classification of traumatic brain injury severity using retrospective data

Classification of traumatic brain injury severity using retrospective data

Assessment Of Jordanian Nurses' Knowledge To Perform Glasgow Coma Scale

Nurses' understanding and experience of applying painful stimuli when assessing components of the Glasgow Coma Scale

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