Effect of Educational Program on Knowledge and Practice of GCS Scale Among Nurses in Private Hospitals

Abstract

Background: Accurate neurological assessment is critical in intensive care settings, yet many nurses lack the training to apply the Glasgow Coma Scale (GCS) reliably, particularly in private hospital environments. Inconsistent GCS application can delay critical interventions, leading to poor patient outcomes. Previous studies highlight knowledge gaps and call for structured educational programs, but limited data exist on their efficacy in South Asian private healthcare settings. Objective: This study aimed to evaluate the effectiveness of a structured educational intervention in improving the knowledge and practical application of the GCS among ICU nurses in private hospitals, with expected outcomes of increased domain-specific accuracy and total assessment scores. Methods: A quasi-experimental pre- and post-test study was conducted over six months in private hospitals in Lahore. Thirty-five registered female ICU nurses, selected via simple random sampling, met inclusion criteria based on their active involvement in neurological assessments. A validated questionnaire measured GCS knowledge and clinical practice before and after a 90-minute training session. Paired t-tests and chi-square analyses were conducted using SPSS v25, with significance set at p<0.05. Ethical approval was granted by the Green International University IRB in accordance with the Helsinki Declaration. Results: Post-intervention knowledge scores increased from a mean of 4.23 to 8.57 (p<0.001, 95% CI: -5.12 to -3.56), and practice scores rose from 4.49 to 8.91 (p<0.001, 95% CI: -5.18 to -3.66), with large effect sizes (d>2.0). Domain-specific improvements were significant in eye and verbal response accuracy, though recognition of maximum GCS score declined. Conclusion: The educational program significantly enhanced ICU nurses’ GCS proficiency, supporting its integration into ongoing clinical training. Regular reinforcement may further improve consistency and reduce critical care assessment errors.