Bold Voices - August 2017 - 18

AT THE BEDSIDE

Glasgow
Coma Scale
Stands the
Test of Time
The scale has become an
integral part of clinical
practice and research
throughout the world.

I

ntroduced in 1974, the Glasgow
Coma Scale (GCS) continues to be
used by healthcare personnel in
more than 80 countries.
"The Glasgow Coma Scale at 40
Years: Standing the Test of Time,"
in The Lancet Neurology, notes that
the scale "has provided a practical

method for bedside assessment of
impairment of conscious level, the
clinical hallmark of acute brain injury."
The scale "has become an integral
part of clinical practice and research
across the world," the GCS website
explains, adding that although varying
approaches have emerged over the
years, none has needed more than
"minor alterations to the content of
the scale and its application.
"The goal of the new structured
schema is therefore to reinforce a
standard approach to assessment and
hence to enhance the consistency of
its use." For instance, "the numbers
of steps in the scales have not been
changed but some terms have been
updated."
The changes offer the clinician
an explanation of what to check and
observe before and after stimulating
the patient. The scale also clarifies
the types of stimulation to use for
responses such as spoken or shouted

requests, fingertip stimulus, and trapezius or supraorbital notch pressure.
"Stimulation by rubbing the knuckles
on the sternum is strongly discouraged;
it can cause bruising and responses
can be difficult to interpret." All three
components include the ability to rate
the assessment as non testable or
NT. The structured assessment now
emphasizes reporting the eye opening,
verbal and motor components rather
than the total sum.
The review cautions that "predictive statements should only be made
in combination with other variables in
a multivariate model." Even with the
advent of computerized tomography
and other magnetic imaging technology, the GCS is part of a common
language to communicate different
clinical processes and how they are
applied to caring for patients.
REFERENCE: Teasdale G, Maas A, Lecky F, Manley
G, Stocchetti N, Murray G. The Glasgow Coma
Scale at 40 years: standing the test of time. Lancet
Neurol. 2014;13(8):844-854.

www.aacnboldvoicesonline.org

18

ECRI Introduces Patient Identification Tools
Using health information technology, the
recommendations strive to prevent patient
misidentification.

T

he ECRI Institute, a nonprofit that works to
improve patient care, introduces a toolkit designed
to help healthcare organizations reduce patient
misidentification.
"ECRI Introduces HIT-based Patient Identification Tools,"
in HealthLeaders Media, estimates that 9 percent of patient
misidentifications lead to "temporary or permanent harm
or death." The article continues, "The goals for improving
patient identification include eliminating inappropriate,
delayed, or unsafe care that can result from inaccurate, inadequate, or irretrievable patient information and consistently
identifying and transferring proper and correct information."
The 88-page toolkit includes educational materials, policy
and procedure recommendations, and audit tools. The recommendations are based on ECRI's deep-dive analysis of more
than 7,600 safety events related to patient identification.
The acronym IDENTIFY outlines the recommendations,
which are as follows:

* Identify: "Electronic fields containing patient identification data should consistently use standard identifier
conventions"
* Detect: "Use a confirmation process to help match the
patient and the documentation"
* Evaluate: "Use standard attributes and attribute formats
in all transactions to improve matching"
* Normalize: "Use a standard display of patient attributes
across the various systems"
* Tailor: "Include distinguishing information enhancing
identification on screens, printouts, and those areas that
require interventions"
* Innovate: "Integrate new technologies to facilitate and
enhance identification"
* Follow up: "Implement monitoring systems to readily
detect identification errors"
* Yield: "Include high-specificity active alerts and notifications to facilitate proper identification"
"I hope the toolkit will stimulate discussions about safe
practices for the use of technology in patient identification,
help facilitate implementation of the safe practices, and build
a foundation for additional work in this area," Lorraine
Possanza, ECRI program director, adds in a news release.


http://www.glasgowcomascale.org/ http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2814%2970120-6/fulltext http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2814%2970120-6/fulltext http://www.aacnboldvoicesonline.org http://www.healthleadersmedia.com/technology/ecri-introduces-hit-based-patient-identification-tools?spMailingID=10792496&spUserID=MTc4ODcwMzIwOTQxS0&spJobID=1140753840&spReportId=MTE0MDc1Mzg0MAS2 https://www.ecri.org/press/Pages/Patient-Identification-Errors.aspx https://www.ecri.org/press/Pages/HITPS-Issues-Recommendations-for-Patient-Identification.aspx

Table of Contents for the Digital Edition of Bold Voices - August 2017

Another Angle
Pres Note Front Teaser
Masthead
New Online Toolkit Shows Crucial Roles of Nurses in Serious Illness Communication
Oct. 31 Deadline to Apply for AACN Research Grants
PCCN or CCRN: Which Certification Is Right for You?
Failed Resuscitations May Increase Stress for Nurses
Updated Cardiac Nursing Course and CMC Review Course Online
New Behavior-Based Pain Assessment Tool
Hospital Rooftop Is a Hive of Activity
Former ICU Nurse Collects 100K Objects for Medical Mosaic
Interventions Reduce Wrong-Patient Orders in NICUs
Increasing Acceptance of Pediatric Telemedicine
The Privilege of Nursing
Effects of Dexmedetomidine
Seizure Risk Much Higher for Sepsis Survivors
Studies Provide Insights Into Reducing Opioid Use
Short-Term Oral Corticosteroids Increase Risk of Adverse Effects
Hospital Staff Becoming Product Innovators
Addressing Barriers to APRN Practice
Survival Rates Higher During Joint Commission Surveys
Effect of Rudeness on Pediatric Team Performance
Glasgow Coma Scale Stands the Test of Time
ECRI Introduces Patient Identification Tools
Reducing Risk Factors in Pediatric Delirium
Bundle Compliance Increases Survival, Reduces Delirium
Fostering Resilience in Healthcare Professionals Who Are Also Moms
Members: Enhance Your Career With an AACN Scholarship
In Our Journals
Transitions
President’s Note
Bold Voices - August 2017 - Cover1
Bold Voices - August 2017 - Cover2
Bold Voices - August 2017 - Pres Note Front Teaser
Bold Voices - August 2017 - Masthead
Bold Voices - August 2017 - Oct. 31 Deadline to Apply for AACN Research Grants
Bold Voices - August 2017 - PCCN or CCRN: Which Certification Is Right for You?
Bold Voices - August 2017 - 7
Bold Voices - August 2017 - Updated Cardiac Nursing Course and CMC Review Course Online
Bold Voices - August 2017 - New Behavior-Based Pain Assessment Tool
Bold Voices - August 2017 - Former ICU Nurse Collects 100K Objects for Medical Mosaic
Bold Voices - August 2017 - Increasing Acceptance of Pediatric Telemedicine
Bold Voices - August 2017 - The Privilege of Nursing
Bold Voices - August 2017 - 13
Bold Voices - August 2017 - Seizure Risk Much Higher for Sepsis Survivors
Bold Voices - August 2017 - Short-Term Oral Corticosteroids Increase Risk of Adverse Effects
Bold Voices - August 2017 - Addressing Barriers to APRN Practice
Bold Voices - August 2017 - Effect of Rudeness on Pediatric Team Performance
Bold Voices - August 2017 - ECRI Introduces Patient Identification Tools
Bold Voices - August 2017 - Bundle Compliance Increases Survival, Reduces Delirium
Bold Voices - August 2017 - Members: Enhance Your Career With an AACN Scholarship
Bold Voices - August 2017 - Transitions
Bold Voices - August 2017 - President’s Note
Bold Voices - August 2017 - Cover3
Bold Voices - August 2017 - Cover4
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