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Glasgow Coma Scale Practice Among Emergency Nurses in China: A Multicenter Cross-Sectional Study
Cairong Liu1, Zhi Da1, Tingting Qi1
1Emergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China.
Journal of Clinical Nursing
|September 30, 2025
Summary
Chinese emergency nurses show significant gaps in applying the Glasgow Coma Scale (GCS) despite theoretical knowledge. Standardized training and guidelines are crucial for improving GCS assessment accuracy.
Area of Science:
- Emergency Medicine
- Nursing Practice
- Neurological Assessment
Background:
- The Glasgow Coma Scale (GCS) is a critical tool for assessing neurological status in emergency settings.
- Standardization and consistent application of the GCS are essential for accurate patient evaluation and effective communication among healthcare professionals.
- Previous studies have highlighted variations in GCS implementation, necessitating an analysis of current practices.
Purpose of the Study:
- To analyze the current practice of the Glasgow Coma Scale (GCS) among emergency nurses in China.
- To identify factors influencing the quality and accuracy of GCS assessments in clinical settings.
- To provide evidence-based recommendations for improving GCS application.
Main Methods:
- A quantitative, multicenter cross-sectional study involving 1740 emergency nurses from 21 provinces in China.
- Data collected via a validated structured questionnaire administered between March and April 2025.
- Statistical analyses included descriptive statistics, chi-square tests, and multiple logistic regression to identify influencing factors.
Main Results:
- Only 52.5% of nurses demonstrated correct GCS application, despite 97.0% possessing theoretical knowledge.
- Significant standardization deficiencies were observed, including a lack of operational guidelines (41.8%) and frequent scoring disagreements (53.7%).
- Standardized training (OR=2.252), manageable workload (OR=1.652), departmental guidelines (OR=1.523), and extensive experience (OR=1.534) positively influenced correct application, while collaboration issues (OR=0.559) and special patient experience (OR=0.520) negatively impacted accuracy.
Conclusions:
- Substantial challenges exist in standardizing GCS practice among Chinese emergency nurses, with a notable gap between theoretical knowledge and clinical application.
- Barriers include insufficient standardized guidelines, inconsistent training, and inadequate interdisciplinary collaboration.
- Implementing national guidelines, simulation-based training, optimized workflows, and alternative assessment tools are recommended to enhance accuracy and patient safety.
