Individuality
Conditions
Brief summary
The assessment of the level of consciousness in patients admitted to intensive care units (ICU) can be complicated because the variables that are evaluated can be interpreted in a different way by different observers. The main objective is to determine interobserver agreement of the Glasgow Coma Scale (GCS) among ICU nurses and assess whether professional experience change the results. Secondary objective: to determine interobserver agreement in each of the three components (motor response, verbal and eye opening) of the GCS
Detailed description
Prospective observational study conducted in a multi-unit 18 beds, neurological and / or neurosurgical patients are included. Variables: Demographic, reason for admission, overall and its components GCS. The neurological assessment was performed by a minimum of 3 nurses. One of them applied algorithm and evaluation technique and all agreed independently valued response to stimuli. Interobserver agreement measured by the intraclass correlation coefficient (ICC) with confidence interval (CI) of 95%. This study was approved by the Ethics Committee of Clinical Trials hospital.
Interventions
None listed
Sponsors
Hospital Universitario Getafe
Study design
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* neurologic patients
Exclusion criteria
* pregnants, under-ages
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Interobserver Correlation | 1 year | interobserver agreement of the Glasgow Coma Scale (GCS) among ICU nurses measured by the intraclass correlation coefficient (ICC) with confidence interval (CI) 95% |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Severity in Glasgow Coma Scale (GCS) by Groups. | 1 year | The Glasgow Coma Scale is divided into three components which are scored separately: ocular response (assessment 1-4 points), motor response (assessment 1-6 points) verbal response (evaluation of 1-5 points). Scores for each component are added together to get the total that will range between a minimum of 3 points (which corresponds to a patient who does not open his eyes and no motor response to stimulation or verbal response) and a maximum value of 15 points (corresponding to a patient with open eyes, obeying orders and maintaining a consistent language). It has been considered that the GCS score between 15 and 13 points corresponds to a slight alteration of consciousness, a score of 12-9 points with moderate impairment and 8 points or less with a serious deterioration in level of consciousness. |
| Years of Professional Experience for Nurses in Critical Care | 1 year | Influence of professional experience in the evaluation of neurological patients |
Countries
Spain
Participant flow
Recruitment details
neurological and neurosurgical patients
Participants by arm
| Arm | Count |
|---|---|
| Neurologic Level Neurologic patients | 125 |
| Total | 125 |
Baseline characteristics
| Characteristic | Neurologic Level |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 58 Participants |
| Age, Categorical Between 18 and 65 years | 67 Participants |
| Age, Continuous | 62 years STANDARD_DEVIATION 15 |
| Region of Enrollment Spain | 125 participants |
| Sex: Female, Male Female | 43 Participants |
| Sex: Female, Male Male | 82 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 125 |
| serious Total, serious adverse events | 0 / 125 |
Outcome results
Primary
Interobserver Correlation
interobserver agreement of the Glasgow Coma Scale (GCS) among ICU nurses measured by the intraclass correlation coefficient (ICC) with confidence interval (CI) 95%
Time frame: 1 year
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Neurologic Level | Interobserver Correlation | 98.9 percentage of correlation |
Secondary
Severity in Glasgow Coma Scale (GCS) by Groups.
The Glasgow Coma Scale is divided into three components which are scored separately: ocular response (assessment 1-4 points), motor response (assessment 1-6 points) verbal response (evaluation of 1-5 points). Scores for each component are added together to get the total that will range between a minimum of 3 points (which corresponds to a patient who does not open his eyes and no motor response to stimulation or verbal response) and a maximum value of 15 points (corresponding to a patient with open eyes, obeying orders and maintaining a consistent language). It has been considered that the GCS score between 15 and 13 points corresponds to a slight alteration of consciousness, a score of 12-9 points with moderate impairment and 8 points or less with a serious deterioration in level of consciousness.
Time frame: 1 year
Population: Neurological and/or neurosurgical patients in ICU
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Neurologic Level | Severity in Glasgow Coma Scale (GCS) by Groups. | 95.0 percentage of correlation |
| Moderate | Severity in Glasgow Coma Scale (GCS) by Groups. | 60.3 percentage of correlation |
| Slight | Severity in Glasgow Coma Scale (GCS) by Groups. | 90.3 percentage of correlation |
Secondary
Years of Professional Experience for Nurses in Critical Care
Influence of professional experience in the evaluation of neurological patients
Time frame: 1 year
Population: Nurses with a minimum experience of three years in intensive care
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Neurologic Level | Years of Professional Experience for Nurses in Critical Care | 14 years |