Consciousness assessment: A questionnaire of current neuroscience nursing practice in Europe

To study practice in consciousness assessment among neuroscience nurses in Europe.

Over the years, several instruments have been developed to assess the level of consciousness for patients with brain injury. It is unclear which instrument is being used by nurses in Europe and how they are trained to use these tools adequately.

A cross-sectional questionnaire, created by the European Association of Neuroscience Nurses Research Committee, was sent to neuroscience nurses in 13 European countries. The countries participated in 2016 with a response period of 3 months for each country.

A total of 331 questionnaires were completed by nurses in 11 different countries. Assessment of consciousness was part of the daily routine for a majority of bedside nurses (95%), with an estimated median frequency of six times per shift. The majority uses a standardised instrument, and the Glasgow Coma Scale is the most common. Most participants assess consciousness primarily for clinical decision-making and report both total scores and subscores. The majority was formally trained or educated in use of the instrument, but methods of training were divers. Besides the estimated frequency of assessments and training, no significant difference was found between bedside nurses and other nurse positions, educational level or kind of institution.

Our study shows that consciousness assessment is part of the daily routine for most nurses working in neurology/neurosurgery/neurorehabilitation wards in Europe. The greatest variation existed in training methods for the use of the instruments, and we recommend standardised practice in the use of assessment scales.

In clinical practice, both managers and staff nurses should focus on formalised training in the use of assessment tools, to ensure reliability and reproducibility. This may also increase the professionalism in the neuroscience nurses' role and performance.