[논문]The Accuracy of Glasgow Coma Scale Knowledge and Performance among Vietnamese Nurses

Hien, Nguyen Thi; Chae, Sun-Mi

The Accuracy of Glasgow Coma Scale Knowledge and Performance among Vietnamese Nurses 원문보기

Purpose: The purpose of this study was to investigate the accuracy of Glasgow Coma Scale (GCS) knowledge and performance among Vietnamese nurses. Methods: A cross-sectional descriptive study was conducted using a questionnaire pertaining to the nurses' knowledge of GCS and a structured evaluation tool to measure the accuracy of their GCS scores. A total of 94 Vietnamese nurses participated in this study, all from a general hospital in Ho Chi Minh City, Vietnam. Data were analyzed by conducting a t-test, a $x^2$ test, and ANOVA. Results: This study found that the vast majority of the nurses (>90%) responded correctly to questions regarding their GCS basic knowledge; however, 52.1% of the nurses answered incorrectly questions related to clinical scenarios requiring the application of the basic knowledge. Regarding the GCS performance, the nurses demonstrated acceptable accuracy rates for each component of GCS, but those who scored well in all three components accounted for only 42.6% of the subject group. These findings indicate that the Vietnamese nurses are not able to integrate their GCS knowledge into actual practice as measured by the accuracy of GCS scoring. Conclusion: This study suggests that new educational strategies should be developed for the Vietnamese nurses to improve their performance on accurate GCS scoring based on theoretical knowledge.

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문제 정의

The purpose of this study was to determine the ac- curacy of GCS knowledge and performance among Viet- namese nurses. The specific aims of the study were: 1) to identify the accuracy of knowledge on GCS; 2) to identify the accuracy of GCS performance; 3) to examine the difference in knowledge on GCS between the groups with incorrect and correct performance; and 4) to exa- mine the difference in knowledge and performance of GCS scoring by general characteristics.
Furthermore their basic knowledge of GCS was not enough to ensure accurate performance of GCS scoring. Therefore this study suggests that a well-developed GCS training program should be delivered to the Vietnamese nurses to contain accuracy of assessment of the consciousness level using GCS, which ultimately results in improving the quality of nursing care.
Most Vietnamese nurses practice GCS scoring by depending on their own understanding. Therefore, this study will make a significant contribution by exploring the accuracy of GCS usage in Vietnamese nurses. Consequently, it could stimulate both nursing schools and hospitals to develop a comprehensive GCS education program so that nurses have satisfactory preparations to provide a high quality of care.
This was a cross-sectional descriptive study identifying the GCS knowledge and performance among the Vietnamese nurses.

제안 방법

A panel of 4 experts compared the two versions and reached an agreement on the same meaning in the English and Vietnamese versions. After the completion of translation, a pilot test was conducted to confirm the accuracy and clarity of the translated questionnaire. Five experienced nurses working in a neurosurgery ward in Vietnam answered all the questions on the translated questionnaire.
Data were collected from July to August, 2010 at CR hospital in Ho Chi Minh City, Vietnam after obtaining permission from the hospital. Before collecting data, the researcher was trained on GCS scoring at a university hospital in Korea and validated her knowledge and performance of GCS in order to provide expert scores as a norm for GCS scoring. The 10-hour GCS training was supervised by an advanced practice nurse (APN) who had a specialty in neurosurgery and vast experience of caring patients with neurosurgical problems for more than 10 years.
The evaluation form includes 3 components of GCS, eye opening, verbal response, and motor response. Both the nurses and the researcher used the same form to assess the consciousness level of the patients and provided a score of each component in GCS, including the total score. The scores measured by the researcher were used as a norm.
Descriptive statistics were used to demonstrate the nurses’ general characteristics, the accuracy of their knowledge, and their GCS scoring performance.
The questionnaire consists of two parts including six questions regarding GCS knowledge. The first section of the questionnaire tested general knowledge on GCS, such as number of the GCS components, and name and score of each component. The other section of the questionnaire describes a clinical scenario that requires application of theoretical knowledge on GCS.
The questionnaire was originally developed to evaluate air rescuers' know- ledge of GCS scoring.
The researcher also concurrently evaluated the consciousness level of the same patients with the nurses.

대상 데이터

The exclusion criteria were: 1) nurses who graduated from a one-year educational program, 2) assistant physicians with three months of nursing education, and 3) nurses with less than one year of working experience. A total of 94 nurses who met the study criteria participated in the study.
Data were collected from July to August, 2010 at CR hospital in Ho Chi Minh City, Vietnam after obtaining permission from the hospital. Before collecting data, the researcher was trained on GCS scoring at a university hospital in Korea and validated her knowledge and performance of GCS in order to provide expert scores as a norm for GCS scoring.
The convenience sampling method was used to recruit the study's participants at the neurology ward, neurosurgical department, and neurosurgery intensive care unit (NCU) in CR Hospital located in Ho Chi Minh City, Vietnam.

데이터처리

Descriptive statistics were used to demonstrate the nurses’ general characteristics, the accuracy of their knowledge, and their GCS scoring performance. The t-test was used to examine the difference in knowledge between the correct and incorrect performance groups. ANOVA and the x² test were used to measure the differences in knowledge and performance by the nurses’ general characteristics.
To examine the difference in knowledge between correct and incorrect performance of GCS, t-test analysis was performed.

이론/모형

ANOVA and the x² test were used to measure the differences in knowledge and performance by the nurses’ general characteristics. The comparisons of group means when significant differences occurred were conducted by using post hoc analysis with the Least Significant Difference (LSD) test.

성능/효과

7%) answered incorrectly on the question about the name of each component. Comparing to the first 5 questions, the Vietnamese nurses showed lower correct an- swer rate regarding the clinical scenario question: less than a half (n=45, 47.9%) had correct answer. The mean total score and the standard deviation were 5.
Although Vietnamese nurses regularly use GCS in their nursing practice, their knowledge and performance of GCS have not been validated. Our results demonstrated the Vietnamese nurses presented fairly good knowledge on the structure of GCS but were lack of knowledge to a clinical case. The nurses in this study presented higher rate of incorrect answer (28.

후속연구

The NCU nurses in this study may have had more specialized knowledge and skills caring for the patients in critical condition, which could explain their higher accuracy in GCS knowledge than others. Further studies may need to examine the relationship between the accuracy in GCS knowledge and working units. Meanwhile a working unit did not affect the GCS performance in the nurses: GCS knowledge of the NCU nurses were not enough to correctly outperform GCS than the other nurses.

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The Accuracy of Glasgow Coma Scale Knowledge and Performance among Vietnamese Nurses 원문보기

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