ABSTRACT
BACKGROUND: The Glasgow Coma Scale (GCS) is one of the methods that has validity for evaluating the consciousness levels of patients in the literature and is accepted by health authorities. AIM: The purpose of this study was to evaluate the inter-rater reliability of GCS in intensive care patients receiving palliative care. STUDY DESIGN: A prospective cross sectional observational study. The study was conducted in a general intensive care unit with 20 beds with patients receiving palliative care. In the unit, 18 nurses worked in two shifts, day and night. Each patient's primary palliative care nurse and two additional researchers were given one minute to independently record the patient's GCS total and subscale scores. All observations were completed within 5 min as there could be significant changes in the patient's GCS score during observations. RESULTS: A total of 258 assessments were completed. For the GCS total scoring, a moderate agreement was found between palliative care nurses and the first researcher-observer (49.0%) and also between palliative care nurses and the second researcher-observer (47.7%). In addition, there was a substantial agreement between the first and second researchers (78.9%) and also between all observers (61.5%) (all p = .001). CONCLUSIONS: Although there was a near-perfect agreement between the two researcher-observers, we found only moderate agreement among all observers (palliative care nurses and two researcher-observers) in the evaluation of GCS total and subscale scores. RELEVANCE TO CLINICAL PRACTICE: We found that lack of knowledge and training on the standardized use of GCS is still a problem for palliative and intensive care units. Because of the diversity of patients requiring GCS assessment in palliative care units, refresher training programs and hands-on workshops on consciousness assessment should be organized regularly for more experienced nurses.
ABSTRACT
AIM: This study was conducted to determine nursing students' rational use of medicines. METHOD: The population of this descriptive study was composed of 1177 students who were studying at a faculty of nursing in Istanbul. The study sample, on the other hand, consisted of 303 students who were selected from the population by the "stratified random sampling" method, a probabilistic sampling method. The sample size was calculated using the Minitab software. Data were collected with data collection form between February and March 2016. In data analysis, percentage, median, Pearson Chi-square and Fisher's Exact test was used. RESULTS: It was found that the average age of the participating nursing students was 20.25±1.71, 85.5% of the participants were female, 98.7% were single, 66.3% graduated from Anatolian High School and 29.4% of them were in their third year of study. Also, 11.6% of the participants used medicines continuously, 16.2% used medicines frequently, the most frequent reason for using medicines (69%) was pain, 93.7% read the prospectus of the medicines they used, 70.6% took their medicines on time, 86.8% were careful about using their medicines before or after meals, 78.5% did not change doses of medicines themselves, 63% stopped using medicines when symptoms of disease were over, 62% did not always take medicines with prescription, and 97.3% used pain relievers most without a prescription. In addition, there were significant differences between the participants' gender and reading the prospectus before using medicines, between having a chronic disease and continuous and frequent use of medicines, and between alcohol consumption and frequent use of medicines (p<0.05). CONCLUSION: The nursing students in our study were found to have inadequacies in some issues related to rational use of medicines (e.g. taking medicines with a prescription, using medicines on time and not changing medicine doses without physician's suggestions). In this context, it is advisable to develop guidance and counseling programs for the development of rational drug use behaviors of nursing students and to include this subject in detail in nursing undergraduate education course curricula.
