Bridging Enrolled Nurses’ educational needs in performing neurological assessment

Abstract

Background: Glasgow coma scale (GCS) tool is used to assess the patients’ neurological status in the surgical/medical wards of an acute tertiary hospital. The enrolled nurses will asses patients’ neurological status with this tool, at every shift of the day, and on patients admission. The assessment has to be accurate and valid to to provide patients with safe care and appropriate treatment. Providing education to bridge the the knowledge and skill gaps of ENs is to built their confidence and competency in performing accurate assessment. Objective: The objective of the project is to improve ENs’ knowledge and compliance in using the GCS tool, and accurate neurological assessment. Methods: Best available evidences were retrieved from the JBI database for implementation and to develop audit tool. JBI PACES and GRIP online programs were used to analyse data and developed action plan. Improvement of content on neurological functions and assessment for teaching were carried out. Pre and post implementation audits were conducted for 10 enrolled nurses on accuracy of GCS assessment in a medical/surgical/ward. Results: Comparing to the baseline audit, accuracy in assessment in eye and papillary response increased: 30%, in verbal response, 40% in motor strength response, and 50% in motor response. Discussion: The positive audit findings showed that knowledge and skill provided patient with safe care. To sustain the practice, audit will be conducted 6 monthly. Continuing education sessions will be scheduled for current and new nurses (Registered and Enrolled nurses). Conclusion: Continuing education on neurological assessment will increase staff confidence to perform assessment accurately. Accurate assessment and timely reporting will lead to early diagnosis and expedite treatment for patients.