Knowledge and Use of Glasgow Coma Scale for Neurological Assessment of Patients Among Nurses in The University of Benin Teaching Hospital, Benin City, Edo State.

ABSTRACT Glasgow Coma Scale (GCS) is a neurological assessment tool that gives a reliable, objective way of recording the level of conscious state of a person. Assessment of consciousness level is considered a primary action of health care practitioners, including nurses, who care for the patients with neurological or neurosurgical problems. Growing evidence suggests that problem is encountered when completing some aspect of the GCS with the potential for performing an incorrect assessment. This study assessed the knowledge and use of Glasgow coma scale in neurological assessment of patients among nurses in the University of Benin Teaching Hospital, Benin City Edo state. A descriptive survey design was used. The participants consists of all nurses (226) working in selected wards/units where unconscious patient are nursed. The instrument for data collection was a pre-tested questionnaire and an observational checklist developed by the researcher. Data collected were analyzed using proportion and means. ANOVAs and Chi-square were used for test of hypotheses at 0.05 level of significance. Result showed that 33.0% have poor knowledge; 25.2% have moderate knowledge and 41.7% have good knowledge of the GCS. Reported usage and proficiency were poor (23.4% and 17.6% respectively) and 60.8% seldom used the GCS. Audit of randomly selected patients’ records confirmed lack of use. Significant differences were found in the knowledge of the nurses and usage of the GCS across the various wards/units (p= 0.000 < 0.05, p =0.000< 0.05) respectively with neuro ward nurses (85.4%) having the highest score on knowledge and A&E nurses (66.7%) recorded the highest score in usage. There were no significant relationship between nurses knowledge and socio-demographics characteristics such as academic qualification, years of experience, age and sex (X2 cal < Ptab at 0.05; P> 0.05) in all variables. However, significant relationship was found between nurses knowledge and usage of GCS (X2 cal >Ptab at 0.05; P< 0.05). Lack of continuous training and update course for nurses on the use of GCS and lack of enforcement by the nursing services department major were the major factors limiting the use of GCS. Although nurses in this study had basic knowledge of GCS but this could not be translated into practical proficiency in performing the GCS. Continuous training and updates course on GCS for nurses, and enforcement of the GCS assessment by the nursing service department among their nurses were recommended.