scholarly journals Interobserver Reliability of Glasgow Coma Scale Scores for Intensive Care Unit Patients

2020 ◽  
Vol 40 (4) ◽  
pp. e18-e26
Author(s):  
Ayda Kebapçı ◽  
Gül Dikeç ◽  
Serpil Topçu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Interobserver Reliability ◽  
Verbal Response ◽  
Coma Scale ◽  
Significant Agreement ◽  
Scale Scores ◽  
Sum Scores ◽  
Intensive Care Unit Nurses

Background Intensive care units frequently use the Glasgow Coma Scale to objectively assess patients’ levels of consciousness. Interobserver reliability of Glasgow Coma Scale scores is critical in determining the degree of impairment. Objective To evaluate interobserver reliability of intensive care unit patients’ Glasgow Coma Scale scores. Methods This prospective observational study evaluated Glasgow Coma Scale scoring agreement among 21 intensive care unit nurses and 2 independent researchers who assessed 202 patients with neurosurgical or neurological diseases. Each assessment was completed independently and within 1 minute. Participants had no knowledge of the others’ assessments. Results Agreement between Glasgow Coma Scale component and sum scores recorded by the 2 researchers ranged from 89.5% to 95.9% (P = .001). Significant agreement among nurses and the 2 researchers was found for eye response (73.8%), motor response (75.0%), verbal response (68.1%), and sum scores (62.4%) (all P = .001). Significant agreement among nurses and the 2 researchers (55.2%) was also found for sum scores of patients with sum scores of 10 or less (P = .03). Conclusions Although the study showed near-perfect agreement between the 2 researchers’ Glasgow Coma Scale scores, agreement among nurses and the 2 researchers was moderate (not near perfect) for subcomponent and sum scores. Accurate Glasgow Coma Scale evaluation requires that intensive care unit nurses have adequate knowledge and skills. Educational strategies such as simulations or orientation practice with a preceptor nurse can help develop such skills.

Glasgow Coma Scale score in the evaluation of outcome in the intensive care unit

1993 ◽  
Vol 21 (10) ◽  
pp. 1459-1465 ◽  
Author(s):  
PAULO G. BASTOS ◽  
XIAOLU SUN ◽  
DOUGLAS P. WAGNER ◽  
ALBERT W. WU ◽  
WILLIAM A. KNAUS
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Coma Scale

APPROPRIATE USE OF THE GLASGOW COMA SCALE IN THE INTENSIVE CARE UNIT: VERBAL SCORES IN INTUBATED PATIENTS

1995 ◽  
Vol 23 (Supplement) ◽  
pp. A228
Author(s):  
Christopher Lentz ◽  
Samir Fakhry ◽  
John Hunt ◽  
Robert Rutledge
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Appropriate Use ◽  
Coma Scale

PENGKAJIAN PASIEN MENGGUNAKAN FOUR SCORE COMA SCALE DI RUANG PERAWATAN INTENSIVE CARE UNIT (ICU)

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Barkah Waladani ◽  
Ning Iswati
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Stem ◽  
Motor Response ◽  
Verbal Response ◽  
Respiratory Pattern ◽  
Average Score ◽  
Coma Scale ◽  
Four Score ◽  
Brain Stem Reflex

Patients with poor conditions or decreased awareness need appropriate assessment to determine the management to be given. Awareness assessments can be done using FOUR (Full Outline of Response) scores with a range of scores from 0 to 16, consisting of eye response, motor response, brain stem reflex and respiration pattern FOUR score is used by nurses in the intensive care unit (Intensive Care Unit). ICU). The method of this study was descriptive analytical and numerator testing between oberserver prospectively to evaluate FOUR score to 100 patients in the ICU from October to December 2017. This study compared FOUR score with the GCS (Glasgow Coma Scale). Each patient was assessed using FOUR score and GCS by nurses. The average score is calculated based on the results obtained in both scoring. The results showed that the numerator test for FOUR score was very good (eye response 0.94, motor response 0.95, brain stem reflex 0.96 and respiratory pattern 1.00) and for GCS it was also very good (eye response 0.94, motoric response 0.95, verbal response 0.97). In predictive terms, GCS is better than FOUR score (characteristic curve value 0.01 difference; GCS 0.76 and FOUR score 0.75). The mortality rate of patients with FOUR scale was the lowest 0 (87%) compared with the lowest GCS score of 3 (70%). FOUR score has an excellent interpersonal and intensivisional level. In contrast to GCS, all components in FOUR score can be assessed even when the patient is installed intubation.

scholarly journals The effect of using Richmond agitation and sedation scale on hospital stay, ventilator dependence, and mortality rate in ICU inpatients: a randomised clinical trial

2020 ◽  
Vol 25 (8) ◽  
pp. 734-746
Author(s):  
Mahbobeh Rashidi ◽  
Shahram Molavynejad ◽  
Nasser Javadi ◽  
Mohammad Adineh ◽  
Assad Sharhani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Hospital Stay ◽  
Glasgow Coma Scale Score ◽  
Randomised Clinical Trial ◽  
Sedation Scale ◽  
Coma Scale ◽  
Hospital Stay Duration

Background Managing the amount of use of sedatives due to their high side effects in the intensive care unit is essential. Sedation-agitation protocols may play an important role in this regard. However, they have not been practically applied in Iran. Aims This study aimed to evaluate the effect of using the Richmond agitation and sedation scale on hospital stay duration and dependency rate on the intensive care unit ventilator system in Ahwaz City, Iran, in 2016–2017. Methods This randomised clinical trial was conducted on 74 patients. The subjects were selected by a stratified sampling method and divided into the experimental ( n = 32) and control ( n = 32) groups. Sedation and agitation levels were managed by the Richmond agitation and sedation scale as soon as the samples were anxious and agitated, and every 6 hours in the intervention group. However, the control group received routine care. The data obtained were analysed by the Statistical Package for the Social Sciences (SPSS). Results There was no significant difference between the two groups in terms of demographic variables, such as age, gender, admission diagnosis and Glasgow coma scale scores on admission. However, they differed in terms of hospital stay duration and ventilator connection ( P < 0.001), Glasgow coma scale score at the separation time from the device ( P < 0.001), Glasgow coma scale score at the discharge time from the intensive care unit ( P < 0.02) and intensive care unit death rate ( P < 0.001). In all cases mentioned previously, the intervention group’s condition was better. Conclusions Based on the results of this study, as well as the approval of validation and reliability of the Richmond agitation and sedation scale in different studies, this protocol can be very effective in optimising the use of sedatives in the intensive care unit.

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