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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.
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.
