Journal of Krishna Institute of Medical Sciences University (Jan 2013)
Effectiveness of Self Instructional Module on Knowledge and Skills Regarding Use of Glasgow Coma Scale in Neurological Assessment of Patients among Nurses Working in Critical Care Units of KLE Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum
Abstract
Background: The brain is the central unit that controls all the functions of our body. The brain cannot function all by its self without the neurons. The proper functioning of the brain and its relationship with the world is known as consciousness. The level of consciousness is the sensitive and reliable indicator of the patients neurological status. The alteration in the consciousness helps to determine if there is any damage in the nervous system that can occur even without visible damage to the head. There are numerous tools used to determine level of consciousness. The most common tool used to determine level of consciousness is the Glasgow Coma Scale (GCS). It was used with ease and helped to standardize clinical observations of the patients with impaired consciousness. A proper neurological assessment using the Glasgow Coma Scale is the essential part of nursing care. It is very essential for the nurse to have knowledge and skills about neurological assessment and the Glasgow Coma Scale.Hence the present study to evaluate the effectiveness of Self Instructional Module (SIM) on knowledge and skill regarding Glasgow Coma Scale was undertaken. Aim and Objectives: 1]To assess the knowledge and skills regarding the use of Glasgow Coma Scale in neurological assessment of patients among the staff nurses. 2] To determine the effectiveness of the Self Instructional Module on knowledge and skills regarding the GCS in neurological assessment of patients. 3] To find association between the pre test knowledge and skills scores and demographic variables. 4] To find the correlation between the knowledge score sand the skills scores regarding the GCS in neurological assessment of patients. Material and Methods: The study was evaluative in nature. A purposive sampling technique was used for the study. A total of 55 staff nurses working in Critical Care Units of KLES Hospital and MRC,Belgaum were selected for the study. A structured questionnaire and an observational checklist was prepared with the expert guidance. Pilot study was conducted and tool was found to be feasible and reliable. Data collected was analyzed by using descriptive and inferential statistics. Results: The findings of the study revealed that during pretest, 41(74.55%) of the staff nurses had average knowledge and14(25.45%) had poor knowledge. After the ad-ministration of Self Instructional Module in post test 38 (69.09%) of staff nurses had good knowledge and 17(30.91%) had average knowledge. The study also revealed that during the pre test all the staff nurses 46(83.64%) had average skill. After the administration of the Self Instructional Module in post-test 35(63.64%)of staff nurses had average skill and 20(36.36%) had good skill. This proved that SIM is an effective method to increase the knowledge and skill of the staff nurses working in critical care units. Further computed paired t test value (40.8) revealed that there was significant gain in knowledge and skill among staff nurses working in critical care units after administration of SIM and probability value of ÷2 contingency table revealed that the knowledge scores and sociodemographic variables were dependent on gender and the skill scores were dependent on the total years of experience. Conclusion: SIM was useful in including the knowledge & skill in using glasgow coma scale in neurological assessment of patients by the nursing staff