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Neuro/Trauma Intensive Care Unit Nurses’ Perception of the Use of the Full Outline of Unresponsiveness Score Versus the Glasgow Coma Scale When Assessing the Neurological Status of Intensive Care Unit Patients

Introduction:This study compares the Full Outline of Unresponsiveness (FOUR) Score scale with the Glasgow Coma Scale (GCS) when evaluating a patient’s level of responsiveness in the neuro/trauma intensive care unit of a large medical center. This new scoring tool evaluates 4 functional categories: eye response, motor response, brainstem reflexes, and respiratory pattern. Aims and Methods:A total of 57 patients 18 years or older were randomly selected as a convenience sample of those admitted to the neuro/trauma intensive care unit and were assessed using both the standard GCS and the FOUR Score scale. The raters then completed a short survey (43 completed) to compare the 2 tools. Results:Rater agreement was very good with the FOUR Score scale and for the GCS; however, nurses favored the use of the FOUR Score scale (81.4%) over the GCS (0.00%) to assess the neurological responsiveness of their patients as the generally accepted assessment tool. Conclusion:The FOUR Score scale provides a reliable neurological assessment of intubated patients where the GCS does not differentiate patient status once intubated.