ArticleBMC nursing2025
Unveiling critical care nurses' knowledge, practice, self-confidence, and perceived barriers affecting the use of the Glasgow Coma Scale: findings for enhancing unconscious patient care.
Article in BMC nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCritical care nurses (CCNs) should be knowledgeable and competent in monitoring and observing neurological assessments to improve unconscious patient care.
objectivesThis study aimed to evaluate the levels and factors affecting CCNs’ knowledge, practice, and self-confidence using the Glasgow Coma Scale (GCS).
methodsA cross-sectional correlational study was conducted among 202 nurses working in critical care units between March and May 2024. A self-administered questionnaire was used to collect data on CCNs’ knowledge, practices, self-confidence, and perceived barriers to GCS use. Statistical significance was set at a p-value of less than 0.05.
resultsThe study revealed that more than half (52.0%) of the CCNs had poor knowledge, and the majority had poor practice and a low level of confidence (76.2% and 68.8%, respectively) in GCS assessment. The most common barriers to implementing GCS assessment among CCNs were excessive workload, inadequate staffing (96.5%), lack of continuous training and updates (93.1%), and inadequate knowledge and skills (88.1%). There was a significant positive correlation between CCNs’ knowledge and practice, confidence levels, and perceived barriers to GCS scores (r = 0.366, p < 0.001; r = 0.221, p = 0.002; and r = 0.383, p < 0.001, respectively). Significant predictors of GCS knowledge included qualification, hospital department, job position, and patient-nurse ratio. Nurses with bachelor’s degrees, assistant positions, and working in the intensive care unit (ICU) demonstrated significantly higher GCS knowledge than those with diplomas, head nurses, and those working in intermediate care units (p < 0.05). Moreover, nurses with a patient-nurse ratio of 1:1 (AOR = 7.630, p = 0.001) were more likely to possess better GCS knowledge. Additionally, nurses who had undergone GCS courses or training (p = 0.002) had higher odds of having good GCS knowledge.
conclusionMost CCNs in this study demonstrated inadequate GCS knowledge and practice, and low confidence in GCS assessment. These findings emphasize the need to implement educational programs, provide adequate staffing, address workload issues to facilitate effective GCS implementation, improve patient care outcomes, and increase CCNs’ confidence levels. CLINICAL TRIAL NUMBER: Not applicable.
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