CNA347 - Emergency Department Glasgow Coma Scale - Proposal for Education Tool - Health Assignment Help

Assignment Task:

Task description: 

Identify an area of specialization in the health setting which interests you. Using research, identify a gap in education which has an impact on outcomes. Write a proposal for an educational tool to help close this gap. 

Criterion 1: 

Identifies an area of specialty within the health setting 

Emergency medicine is specialized services to deliver acute medical services from the Emergency Department (ED), and ED has a highly skillful clinician to provide emergency treatment (Cameron et al. 2014). However, during my recent placement at ED, I have noted that nurses working in ED have a variety of knowledge and practice on using the Glasgow coma scale (GCS) to assess the level of consciousness of the patient with a neurological problem. 

Criterion 2: 

Relevant research of a high level is used to identify an educational gap within this specialty area 

GCS is the neurological assessment tool that measures the depth and duration of impaired consciousness which is important to identify the early deterioration in the level of consciousness (Braine & Cook 2017). Nagalakshmi, Sagarkar & Sakharkar (2018) write that GCS is the 15-point scale to evaluate the consciousness on the basis of response to external stimuli; eye and verbal response and motor responsiveness. Nurse’s critical thinking skills, knowledge, and competence are the foundation of GCS applicability (Braine & Cook 2017). A quantitative descriptive cross-sectional study published in the MEDLINE Complete database, using GCS questionnaire methods has explored the knowledge and competency level of ED and outpatient department nurses in assessing GCS (Basauhra Singh et al. 2016). The result of this study shows that only 2.96% of nurses have good, 41.48% have satisfactory knowledge about the GCS and more than half 55.56% of participants have poor knowledge in assessing GCS. Therefore, further education and practice on GCS for nurses working in the ED to develop their knowledge are crucial. 

Correspondingly, a systematic review with a cohort study, case-control, cross-sectional, and descriptive studies published in The Joanna Briggs Institute (JBI) database has explored the demographic factors that affect nurse’s performance on assessing consciousness level (Matter & Chan 2011). The result of the study concludes that knowledge and experience are the significant factors that affect acute care settings nurses; such as ED and intensive care unit (ICU) nurse's ability to conduct the level of consciousness assessment (Matter & Chan 201). This systematic study also suggested the formal training and education session for nurses on a continual basis to maintain standard and uniformity in the level of consciousness assessment. Similarly, another cross-sectional analytical study conducted with 127 nurses working in ED and ICU with the aim of evaluating their knowledge about GCS published in BASE database indicates that despite number of years after graduation, experience and work in critical settings, nurses have restricted knowledge in using GCS, thus further education and training is required (Santos et al. 2016). 

Criterion 3:
Analysis of the impact of educational gap undertaken 

Recognizing and responding to clinical deterioration in acute health care is one of the National Safety and Quality Health Service Standard (NSQHSS) developed by Australian Commission on Safety and Quality in Health Care (ACSQHC) which requires all health professionals to ensure patient’s deterioration is recognized promptly, and action is taken immediately (ACSQHC 2012). Massey, Chaboyer & Anderson (2017) write that there are many studies and systematic reviews providing insights to the risk that hospitalized patients faced due to the lack of early detection and identification of deterioration. They further write that failure to recognize and respond to patient deterioration because of the limited knowledge in assessing patients such as; vital signs and GCS assessment has led to an increased risk of adverse events in hospitalized patients which might have been avoided if the deterioration was rectified and responded earlier. 

Chou et al. (2017) discuss that poor knowledge and skills of nurses in assessing consciousness of patients with traumatic brain injury, and neurological deficiency is associated with poorer prognosis and requiring more intensive care which increases mortality and morbidity and results in an adverse outcome. Ahamed & Ebraheim (2017) write that neurological assessment is one of the fundamental aspects of nursing care; hence nurses working in critical care should use GCS assessment as easily as other routine observations such as vital signs. They further write that despite, GCS being a universally accepted tool to assess the level of consciousness in nursing practice, many nurses are using it inaccurately without following the instruction. This might impact nurse’s ability to develop proper nursing care plans depending on the actual needs of the patients, compromise early detection of potential health issues and can affect the quality of nursing care which reflects on poor patient outcomes (Ahamed & Ebraheim 2017). Furthermore, misinterpretation and misapplication of GCS create an issue because it is an important mechanism of communication between the clinicians regarding the patient's condition (Mattar, Liaw & Chan 2013). 

Criterion 4:
The target audience for education tool clearly identified 

The prominence of undistinguishable patients presenting to ED without an accurate and clear medical diagnosis and baseline data to differentiate among critically ill and well, ED nurses required to be highly skilled and knowledgeable at performing right and timely patient assessment (Munroe et al. 2015). Honkala et al. (2017) mention that ED nurses are the first ones to interact with the patients when they arrive at the hospital, therefore, adequate neurological assessment skills are essential for the nurses working in ED to assess the neurological problem and level of consciousness. Hence, the targeted audiences for the educational tool are nurses working in the ED. The designed educational tool is expected to increase ED nurse's knowledge in conducting GCS assessment in an effective and accurate way. 

Criterion 5:
Provides clear details of a proposed education tool 

Education plays a vital role to achieve organizational goals with the blend of organizational and workforce interests (Crookes, Crookes & Walsh 2013). Xu (2016) writes that although nurses possess expertise as a first-line care providers in hospitals, their experience, and knowledge in using some of the assessment tools on the patient can be limited, therefore, nurses working in different settings need additional instruction, guidance and up to date education to implement such assessment tools. He further writes that there are various teaching tools and strategies available for nurses, importantly, the educational tool used for nurses should be meaningful, engaging and also should be clear and simple. I am going to use a short video presentation as my educational tool to facilitate ED nurses to use GCS correctly to assess a patient’s level of consciousness correctly. Salina et al. (2012) discuss that video presentations are widely used educational tools in nursing because of the auditory and visual combined enhancement within the traditional lecture which can be the power for the acquisition of clinical competencies and to reduce theory and practice gap in nursing practice. They further discuss that teaching video used in an emergency can enhance performance quality. The video presentation will include some informative slides followed by the role-playing of a nurse conducting GCS assessment to a patient with an altered level of consciousness. The title of the presentation will be ‘Structured GCS assessment tool for ED nurses’. The presentation begins with considering any factors that impact the assessment of the patients such as cognitive impairment and local factors such as swelling of eyes. Then, the video will continue by observing spontaneous behaviors in three behaviors; eye-opening, verbal response and motor response and the score of the assessment will be used to determine the degree of impairment. 

This CNA347: Health Assignment has been solved by our Health Experts at My Uni Paper. Our Assignment Writing Experts are efficient to provide a fresh solution to this question. We are serving more than 10000+ Students in Australia, UK & US by helping them to score HD in their academics. Our experts are well trained to follow all marking rubrics & referencing style.

Be it a used or new solution, the quality of the work submitted by our assignment experts remains unhampered. You may continue to expect the same or even better quality with the used and new assignment solution files respectively. There’s one thing to be noticed that you could choose one between the two and acquire an HD either way. You could choose a new assignment solution file to get yourself an exclusive, plagiarism (with free Turnitin file), expert quality assignment or order an old solution file that was considered worthy of the highest distinction.