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Loutfy A, Elzeiny A, Sabek EM, El-Monshed AH, Shahin MAH, Mohamed FSA. Effect of an educational program on pediatric nurses' knowledge, practice, and self-confidence about level of consciousness scales. J Pediatr Nurs 2023; 73:e570-e578. [PMID: 37926670 DOI: 10.1016/j.pedn.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/28/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Nurses of pediatric acute critical care units routinely assess the Level of Consciousness (LOC). The precise, exact, and restriction-free evaluation tool aids pediatric nurses in LOC assessment and clinical decision-making. This study aimed to examine the effect of an educational program on pediatric nurses' knowledge, practice, and self-confidence about level of consciousness scales. METHODS This pretest-post, single-group, quasi-experimental, double-site study included 49 pediatric nurses. The Glasgow Coma Scale (GCS)/Pediatric Glasgow Coma Scale (PGCS) and Pediatric Full Outline of UnResponsiveness Score Scale (PFSS) knowledge questionnaire and pediatric nurse practice checklist were developed and adopted. Self-reflection confidence statements were rated 1-5 (not confident-confident). RESULTS The results of the study indicate that there were significant increases in knowledge, practice, and self-confidence after the intervention. The paired samples tests revealed that knowledge scores significantly increased from the pretest to the posttest for both GCS/PGCS (pretest mean:7.91, posttest mean:9.95) and PFSS (pretest mean:2.1, posttest mean:6.79). Practice scores also showed significant improvement for both GCS/PGCS (pretest mean: 4.12, post-test mean: 6.22) and PFSS (pretest mean: 2.46, post-test mean: 5.79). Furthermore, self-confidence significantly improved for GCS/PGCS (pretest mean:16.08, posttest mean:18.79) and PFSS (pretest mean:10.32, posttest mean:17.81). The statistical analyses supported the significance of these improvements (p < 0.001 for all except self-confidence in GCS/PGCS with p < 0.005). CONCLUSION The educational program improved pediatric nurses' GCS/PGCS and PFSS knowledge, practice, and self-confidence. IMPLICATIONS TO PRACTICE Effective teaching of pediatric nurses is required to address gaps in care practices and improve the use of the Consciousness Level Assessment Scales.
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Affiliation(s)
- Ahmed Loutfy
- Department of Nursing, College of Health Sciences, University of Fujairah, UAE; Pediatric Nursing Department, Faculty of Nursing, Beni-Suef University, Egypt.
| | - Amina Elzeiny
- Nursing Director, Makkah Medical Center Hospital, Saudi Arabia
| | - Elsayed Mahmoud Sabek
- Critical Care and Emergency Nursing, Faculty of Nursing, Beni-Suef University, Egypt; Coordinator of Faculty of Nursing, Beni Suef National University, Egypt
| | - Ahmed Hashem El-Monshed
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing-Mansoura University, Egypt; Department of Nursing, College of Health and Sport Sciences, University of Bahrain, Bahrain
| | - Mahmoud Abdel Hameed Shahin
- Associate Professor of Critical Care Nursing, Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
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Andualem H, Beyene T, Tuli W. 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. Ethiop J Health Sci 2022; 32:895-904. [PMID: 36262709 PMCID: PMC9554765 DOI: 10.4314/ejhs.v32i5.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Glasgow Coma Scale is a dependable and objective neurological assessment instrument used for determining and recording a patient's level of consciousness. Therefore, the knowledge, practice, and factors affecting Glasgow coma scale evaluation among nurses working in adult intensive care units of federally administered hospitals in Addis Ababa, Ethiopia, were investigated. METHODS From April 4 to 24, 2020, 121 Adult Intensive Care Unit nurses at Ethiopian federal hospitals participated in an institutional-based cross-sectional survey with a standardized self-administered questionnaire. The information was entered into Epidata version 3.1 and then exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regressions were used to examine the relationships between independent and dependent variables. RESULT According to this study, nurses working in the Adult Intensive Care Unit of federal hospitals in Addis Ababa, Ethiopia, had poor knowledge (51.2%) and poor practice (62%) of the Glasgow Coma Scale's basic theoretical notions and competencies. Furthermore, the education and gender of nurses were linked to their level of knowledge and clinical practice. Being a male and having a master's degree were both significantly linked with knowledge(AOR = 4.13, 95% CI: (1.87-9.1)), (AOR=7.4, 95% CI: (1.4-38)) and practice (AOR = 2.7, 95% CI: (1.2-6)), (AOR = 10.4, 95% CI: (2.0-53)) respectively. CONCLUSION The findings from this study showed that nurses had poor knowledge and application of practice-related clinical scenarios on the Glasgow Coma Scale.
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Affiliation(s)
- Habtamu Andualem
- Department of Emergency, St. Peter Hospital, Addis Ababa, Ethiopia
| | - Temesgen Beyene
- Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wagari Tuli
- Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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KC B, Adil MZ. Knowledge of Glasgow Coma Scale among Nurses in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:723-726. [PMID: 36705209 PMCID: PMC9446504 DOI: 10.31729/jnma.7673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/28/2022] [Indexed: 01/31/2023] Open
Abstract
Introduction Glasgow Coma Scale is a dependable and unprejudiced neurological evaluation kit applied for evaluating and recording the level of consciousness of a person. Evaluation of consciousness level using Glasgow Coma Scale is a tool necessitating knowledge which is vital in identifying immediate worsening of level of consciousness. Critical thinking used with skill and knowledge in Glasgow Coma Scale is the groundwork of nursing practice to avoid delay in clinical worsening and treatment. The aim of this study was to find out the prevalence of inadequate knowledge of Glasgow Coma Scale among nurses working in a tertiary care centre. Methods A descriptive cross-sectional study was performed among registered nurses working in different wards and Intensive Care Unit at tertiary care centre between 1 June 2022 and 30 June 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: 2905202211). Convenience sampling was done. Self-administered structured questionnaires were used to collect data to assess the knowledge of Glasgow Coma Scale. Point estimate and 95% Confidence Interval were calculated. Results Among 91 nurses, inadequate knowledge of the Glasgow Coma Scale was found in 48 nurses (52.70%) (42.30-63.10, 95 % Confidence Interval). Conclusions The prevalence of inadequate knowledge of the Glasgow Coma Scale among nurses was found to be similar when compared to other studies done in similar settings. Keywords glasgow coma scale; knowledge; nurses; tertiary care centre.
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Affiliation(s)
- Bidur KC
- Department of Neurosurgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal,Correspondence: Dr Bidur KC, Department of Neurosurgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal. , Phone: +977-9846056689
| | - Mohamed Zaidan Adil
- Department of Neurosurgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
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Ehwarieme TA, Anarado AN, Osian EA, Nnahiwe B. Clinical nurses knowledge, skills and learning needs about glasgow coma scale for neurological patients’ assessment in tertiary hospitals in Edo state, Nigeria: A mixed method study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Camargo MM, Furieri LB, Lima EDFA, Lucena ADF, Fioresi M, Romero WG. Cross mapping between clinical indicators for assistance in intensive care and nursing interventions. Rev Bras Enferm 2020; 73:e20190728. [PMID: 32901752 DOI: 10.1590/0034-7167-2019-0728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/13/2020] [Indexed: 08/30/2023] Open
Abstract
OBJECTIVE Identify the main clinical indicators for assistance in the Intensive Care Unit (ICU) and map them in the nursing interventions described by the Nursing Interventions Classification (NIC). METHODS Integrative literature review study, followed by cross-mapping between clinical indicators for assistance in the ICU care and NIC nursing interventions and activities. RESULTS 36 articles were identified, which resulted in 285 clinical indicators for ICU care, with mechanical ventilatory assistance, pain, sedation, psychomotor agitation, delirium, anxiety, altered heart rate, diet by naso tube / oroenteral and diarrhea the clinical indicators for assistance in the ICU the most prevalent. These were mapped in 12 Nursing Interventions Classification interventions and 130 nursing activities. FINAL CONSIDERATIONS It is concluded that the clinical indicators for ICU care associated with Nursing Interventions Classification are concrete data that assist intensive care nurses in their clinical practice.
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Affiliation(s)
| | | | | | | | - Mirian Fioresi
- Universidade Federal do Espírito Santo. Vitória, Espírito Santo, Brazil
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Arruda PLD, Xavier RDO, Lira GG, Arruda RGD, Melo RAD, Fernandes FECV. Clinical evolution and survival of neurocritical patients. Rev Esc Enferm USP 2019; 53:e03505. [PMID: 31508731 DOI: 10.1590/s1980-220x2018016903505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 03/14/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the clinical evolution and survival of neurocritical patients in Hospital Units. METHOD Cohort with hospitalized patients in follow-up treatment in public and private hospitals between September 2012 and June 2016. Data were initially analyzed from descriptive and inferential statistics. The Kaplan-Meier indicator was applied as a form of survival analysis. The Cox proportional hazards regression model was used to analyze the prognostic factors by calculating the hazard ratio. RESULTS Participation of 1,289 patients in the study. Patients with a higher score on the Glasgow Coma Scale presented greater survival, and the one-point increase in the scale score corresponded to 42% improvement in their survival. In the analysis of survival, sex and the use of vasoactive drugs showed a significant difference. CONCLUSION Female patients with a better score on the Glasgow Coma Scale and using vasoactive drugs had higher survival rates.
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Cook NF, Braine ME, Trout R. Nurses' understanding and experience of applying painful stimuli when assessing components of the Glasgow Coma Scale. J Clin Nurs 2019; 28:3827-3839. [DOI: 10.1111/jocn.15011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Neal F. Cook
- School of Nursing Ulster University Londonderry UK
| | - Mary E. Braine
- School of Nursing, Midwifery, Social Work & Social Sciences University of Salford Salford UK
| | - Ruth Trout
- School of Healthcare and Social Work Buckinghamshire New University Uxbridge UK
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Okada Y, Kiguchi T, Iiduka R, Ishii W, Iwami T, Koike K. Association between the Japan Coma Scale scores at the scene of injury and in-hospital outcomes in trauma patients: an analysis from the nationwide trauma database in Japan. BMJ Open 2019; 9:e029706. [PMID: 31366660 PMCID: PMC6677991 DOI: 10.1136/bmjopen-2019-029706] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Japan Coma Scale (JCS) is a grading system used to evaluate disturbed consciousness in prehospital care settings. We aimed to identify the association between the JCS levels at the scene with in-hospital mortality, as well as the discrimination ability for the outcomes. DESIGN A retrospective cohort study based on the nationwide trauma database in Japan. SETTING Multicentre cohort study using data from the Japan Trauma Data Bank, which is a nationwide, prospective, observational trauma registry derived from 235 hospitals. PARTICIPANTS Adult trauma victims transferred directly from the scene of injury to the hospital from January 2004 to December 2017 were eligible for inclusion. PRIMARY AND SECONDARY OUTCOMES Primary outcome was the association between the JCS levels at the scene with in-hospital mortality. We conducted a multivariate logistic regression analysis to calculate the adjusted ORs of JCS levels with 95% CIs for in-hospital mortality. We also calculated the c-statistics for in-hospital mortality. RESULTS 164 723 patients were included in the analysis. In a multivariate logistic regression analysis, the corresponding adjusted ORs of JCS levels 2 and 3 referred to level 1 for in-hospital mortality were 4.1 (95% CI 3.8 to 4.4) and 26.0 (95% CI 24.8 to 27.2). The c-statistics of the JCS level for in-hospital mortality was 0.845 (95% CI 0.842 to 0.849). CONCLUSIONS Data from large multicentre prospective registry revealed strong associations of the JCS level at the scene of injury with in-hospital mortality as well as the good discriminatory performance for this outcome.
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Affiliation(s)
- Yohei Okada
- Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Preventive Services, Graduate School of Public Health, Kyoto University, Kyoto, Japan
- Emergency and Critical Care Medicine, Japanese Red Cross Society, Kyoto Daini Hospital, Kyoto, Japan
| | - Takeyuki Kiguchi
- Department of Preventive Services, Graduate School of Public Health, Kyoto University, Kyoto, Japan
| | - Ryoji Iiduka
- Emergency and Critical Care Medicine, Japanese Red Cross Society, Kyoto Daini Hospital, Kyoto, Japan
| | - Wataru Ishii
- Emergency and Critical Care Medicine, Japanese Red Cross Society, Kyoto Daini Hospital, Kyoto, Japan
| | - Taku Iwami
- Department of Preventive Services, Graduate School of Public Health, Kyoto University, Kyoto, Japan
| | - Kaoru Koike
- Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Severo IM, Kuchenbecker RDS, Vieira DFVB, Lucena ADF, Almeida MDA. Risk factors for fall occurrence in hospitalized adult patients: a case-control study. Rev Lat Am Enfermagem 2018; 26:e3016. [PMID: 30110094 PMCID: PMC6091377 DOI: 10.1590/1518-8345.2460.3016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 04/11/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE to identify risk factors for falls in hospitalized adult patients. METHODS a matched case-control study (one control for each case). A quantitative study conducted in clinical and surgical units of a teaching hospital in Southern Brazil. The sample comprised 358 patients. Data were collected over 18 months between 2013-2014. Data analysis was performed with descriptive statistics and conditional logistic regression using Microsoft Excel and SPSS version 18.0. RESULTS risk factors identified were: disorientation/confusion [OR 4.25 (1.99 to 9.08), p<0.001]; frequent urination [OR 4.50 (1.86 to 10.87), p=0.001]; walking limitation [OR 4.34 (2.05 to 9.14), p<0.001]; absence of caregiver [OR 0.37 (0.22 to 0.63), p<0.001]; postoperative period [OR 0.50 (0.26 to 0.94), p=0.03]; and number of medications administered within 72 hours prior the fall [OR 1.20 (1.04 to 1.39) p=0.01]. CONCLUSION risk for falls is multifactorial. However, understanding these factors provides support to clinical decision-making and positively influences patient safety.
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Affiliation(s)
- Isis Marques Severo
- PhD, RN, Serviço de Terapia Intensiva, Hospital de Clínicas de Porto
Alegre, Porto Alegre, RS, Brazil
| | | | | | - Amália de Fátima Lucena
- PhD, Adjunct Professor, Escola de Enfermagem, Universidade Federal
do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Miriam de Abreu Almeida
- PhD, Adjunct Professor, Escola de Enfermagem, Universidade Federal
do Rio Grande do Sul, Porto Alegre, RS, Brazil
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