Cairong Liu, Zhi Da, Tingting Qi, Xueli Ji, Feng Chen, Yangchun Zhang
{"title":"格拉斯哥昏迷量表在急诊护士中的应用：一项多中心横断面研究。","authors":"Cairong Liu, Zhi Da, Tingting Qi, Xueli Ji, Feng Chen, Yangchun Zhang","doi":"10.1111/jocn.70124","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To analyse current Glasgow Coma Scale practice among emergency nurses in China and identify factors influencing assessment quality.</p><p><strong>Design: </strong>A quantitative, multicenter cross-sectional design.</p><p><strong>Methods: </strong>A convenience sample of 1740 emergency nurses from secondary and tertiary hospitals across 21 provinces completed a validated structured questionnaire between March and April 2025. Participants had at least 6 months of emergency nursing experience. Data analysis included descriptive statistics, chi-square tests, and multiple logistic regression to examine factors influencing correct Glasgow Coma Scale application.</p><p><strong>Results: </strong>Participants had a mean age of 29.8 years (SD = 6.2). Only 52.5% of nurses demonstrated correct Glasgow Coma Scale application despite 97.0% having theoretical knowledge of scoring criteria. While 56.8% had received Glasgow Coma Scale training, significant standardisation deficiencies emerged. Notably, 41.8% of departments lacked operational guidelines, and 53.7% of nurses experienced scoring disagreements with colleagues. Clinical utilisation varied substantially by patient population: traumatic brain injury (97.8%), neurological diseases (96.9%), and systemic critical illness (85.8%). Multivariate analysis identified six significant factors influencing correct application: standardised training (OR = 2.252, 95% CI: 1.789-2.825), manageable workload ≤ 4 patients/shift (OR = 1.652, 95% CI: 1.327-2.057), departmental guidelines (OR = 1.523, 95% CI: 1.233-1.881), extensive work experience ≥ 9 years (OR = 1.534, 95% CI: 1.182-1.992), while multidisciplinary collaboration issues (OR = 0.559, 95% CI: 0.439-0.712) and special patient experience (OR = 0.520, 95% CI: 0.406-0.666) were associated with reduced accuracy.</p><p><strong>Conclusion: </strong>Substantial standardisation challenges exist in Glasgow Coma Scale practice among Chinese emergency nurses, characterised by significant gaps between theoretical knowledge and clinical application. Major barriers include insufficient standardised guidelines, inconsistent training approaches, and inadequate interdisciplinary collaboration.</p><p><strong>Impact: </strong>Healthcare administrators should develop national standardised guidelines, implement simulation-based training programs, optimise emergency workflows, and integrate alternative assessment tools to enhance consciousness assessment accuracy and improve patient safety.</p><p><strong>Reporting method: </strong>STROBE statement adherence.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Glasgow Coma Scale Practice Among Emergency Nurses in China: A Multicenter Cross-Sectional Study.\",\"authors\":\"Cairong Liu, Zhi Da, Tingting Qi, Xueli Ji, Feng Chen, Yangchun Zhang\",\"doi\":\"10.1111/jocn.70124\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To analyse current Glasgow Coma Scale practice among emergency nurses in China and identify factors influencing assessment quality.</p><p><strong>Design: </strong>A quantitative, multicenter cross-sectional design.</p><p><strong>Methods: </strong>A convenience sample of 1740 emergency nurses from secondary and tertiary hospitals across 21 provinces completed a validated structured questionnaire between March and April 2025. Participants had at least 6 months of emergency nursing experience. Data analysis included descriptive statistics, chi-square tests, and multiple logistic regression to examine factors influencing correct Glasgow Coma Scale application.</p><p><strong>Results: </strong>Participants had a mean age of 29.8 years (SD = 6.2). Only 52.5% of nurses demonstrated correct Glasgow Coma Scale application despite 97.0% having theoretical knowledge of scoring criteria. While 56.8% had received Glasgow Coma Scale training, significant standardisation deficiencies emerged. Notably, 41.8% of departments lacked operational guidelines, and 53.7% of nurses experienced scoring disagreements with colleagues. Clinical utilisation varied substantially by patient population: traumatic brain injury (97.8%), neurological diseases (96.9%), and systemic critical illness (85.8%). Multivariate analysis identified six significant factors influencing correct application: standardised training (OR = 2.252, 95% CI: 1.789-2.825), manageable workload ≤ 4 patients/shift (OR = 1.652, 95% CI: 1.327-2.057), departmental guidelines (OR = 1.523, 95% CI: 1.233-1.881), extensive work experience ≥ 9 years (OR = 1.534, 95% CI: 1.182-1.992), while multidisciplinary collaboration issues (OR = 0.559, 95% CI: 0.439-0.712) and special patient experience (OR = 0.520, 95% CI: 0.406-0.666) were associated with reduced accuracy.</p><p><strong>Conclusion: </strong>Substantial standardisation challenges exist in Glasgow Coma Scale practice among Chinese emergency nurses, characterised by significant gaps between theoretical knowledge and clinical application. Major barriers include insufficient standardised guidelines, inconsistent training approaches, and inadequate interdisciplinary collaboration.</p><p><strong>Impact: </strong>Healthcare administrators should develop national standardised guidelines, implement simulation-based training programs, optimise emergency workflows, and integrate alternative assessment tools to enhance consciousness assessment accuracy and improve patient safety.</p><p><strong>Reporting method: </strong>STROBE statement adherence.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>\",\"PeriodicalId\":50236,\"journal\":{\"name\":\"Journal of Clinical Nursing\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jocn.70124\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.70124","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Glasgow Coma Scale Practice Among Emergency Nurses in China: A Multicenter Cross-Sectional Study.
Aim: To analyse current Glasgow Coma Scale practice among emergency nurses in China and identify factors influencing assessment quality.
Design: A quantitative, multicenter cross-sectional design.
Methods: A convenience sample of 1740 emergency nurses from secondary and tertiary hospitals across 21 provinces completed a validated structured questionnaire between March and April 2025. Participants had at least 6 months of emergency nursing experience. Data analysis included descriptive statistics, chi-square tests, and multiple logistic regression to examine factors influencing correct Glasgow Coma Scale application.
Results: Participants had a mean age of 29.8 years (SD = 6.2). Only 52.5% of nurses demonstrated correct Glasgow Coma Scale application despite 97.0% having theoretical knowledge of scoring criteria. While 56.8% had received Glasgow Coma Scale training, significant standardisation deficiencies emerged. Notably, 41.8% of departments lacked operational guidelines, and 53.7% of nurses experienced scoring disagreements with colleagues. Clinical utilisation varied substantially by patient population: traumatic brain injury (97.8%), neurological diseases (96.9%), and systemic critical illness (85.8%). Multivariate analysis identified six significant factors influencing correct application: standardised training (OR = 2.252, 95% CI: 1.789-2.825), manageable workload ≤ 4 patients/shift (OR = 1.652, 95% CI: 1.327-2.057), departmental guidelines (OR = 1.523, 95% CI: 1.233-1.881), extensive work experience ≥ 9 years (OR = 1.534, 95% CI: 1.182-1.992), while multidisciplinary collaboration issues (OR = 0.559, 95% CI: 0.439-0.712) and special patient experience (OR = 0.520, 95% CI: 0.406-0.666) were associated with reduced accuracy.
Conclusion: Substantial standardisation challenges exist in Glasgow Coma Scale practice among Chinese emergency nurses, characterised by significant gaps between theoretical knowledge and clinical application. Major barriers include insufficient standardised guidelines, inconsistent training approaches, and inadequate interdisciplinary collaboration.
Impact: Healthcare administrators should develop national standardised guidelines, implement simulation-based training programs, optimise emergency workflows, and integrate alternative assessment tools to enhance consciousness assessment accuracy and improve patient safety.
Reporting method: STROBE statement adherence.
Patient or public contribution: No patient or public contribution.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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