A Descriptive Study to assess the Knowledge and Knowledge Related to Practice Regarding Four Score Scale among Staff Nurses Working in ICU at Selected Hospitals, with a view to Prepare Planned Teaching Programme
Donit John Vice Principal, Aurangabad College of Nursing, Chh. Sambhajinagar, Maharashtra, India
Malha Ashok Nagre Staff Nurse, Government Medical College and Hospital, Chh. Sambhajinagar, Maharashtra,, India
Manorama Kashyap Associate Professor & Head, Department of Medical Surgical Nursing, Godavari College of Nursing, Jalgaon, Maharashtra,, India
Address for correspondence: Donit John, Vice Principal, Aurangabad College of Nursing, Chh. Sambhajinagar, Maharashtra, India E-mail: donitjohn23@gmail.com
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Malha Ashok Nagre, Manorama Kashyap, Donit John. A descriptive Study to assess the Knowledge and
Knowledge Related to Practice Regarding Four Score Scale among Staff Nurses Working in ICU at Selected
Hospitals, with a view to Prepare Planned Teaching Programme. Int J Practical Nurs. 2026; 14(1): 07-16.
Timeline
Received : November 24, 2025
Accepted : December 24, 2025
Published : April 30, 2026
Abstract
A descriptive study to assess the knowledge and knowledge related to practice regarding FOUR score scale among staff nurses working in ICU at selected hospitals, with a view to prepare planned teaching programme.
Methods and Materials: The research approach used was quantitative evaluator approach. The research design selected for the univariant descriptive research design. The setting was ICU at selected hospitals. The sample includes 100 staff nurses working in ICU at selected hospitals; sampling technique was used purposive sampling technique. The structure knowledge questionnaire was used to collect data from samples. The pilot study was conducted with 10 samples. Reliability was established by Guttmann split half method. Data was analyzed by
using descriptive and inferential statistics. Results: For the assessment purpose the total score 21 of knowledge was divided in to three groups like poor (0-7 score), average (8-14 score) and good (15-21 score). For the assessment purpose the total score 9 of knowledge related to practice regarding FOUR score scale was divided in to three groups like poor (0-3 score), average (4-6 score) and good (7-9 score). For the assessment purpose the otal score
30 of knowledge was divided in to three groups like poor (0-10 score), average (11-
20 score) and good (21-30 score). The average knowledge score regarding FOUR
score scale among staff nurses working in ICU at selected hospitals was 6.00 with
the standard deviation of 1.49. The mean percentage score was 28.57%. The averag knowledge score related to practice regarding FOUR score scale among staff nurses
working in ICU at selected hospitals was 2.89 with the standard deviation of 0.98.
The mean percentage score was 32.11%. The average knowledge & knowledge
related practice regarding FOUR score scale was 8.89 with the standard deviation
of 2.03. The mean percentage score was 29.63%.
Interpretation and Conclusion: The data were analyzed by applying descriptive
and inferential statistics. The result of the study indicated that staff nurses working
in ICU at selected hospitals having poor knowledge regarding FOUR score scale.
References
1. By world health organization, https://www. who.int/violence_injury_prevention/road_ traffic /activitie s/ neurotrauma/en/
2. Sharath S. Nair, Anilkumar Surendran, Rajmohan B. Prabhakar, Meer M. Chisthi (2017), Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study, International surgery journal, Vol. 4, No. 2, (2017), DOI: http://dx.doi.org/10.18203/2349-2902. isj20170209, https://www.ijsurgery.com/ index.php/isj/article/view/975
3. Mayfield brain and spine, https:// mayfieldclinic.com/pe-tbi.htm
4. From Wikipedia, the free encyclopedia, https://en.wikipedia.org/wiki/Spinal_cord_ injury.
5. From Wikipedia, the free encyclopedia, https://en.wikipedia.org/wiki/FOUR_score.
6. Y. Kocak, S. Ozturk, F. Ege, A. H. Ekmekci, (2012) A useful new coma scale in acute stroke patients: FOUR score, Anaesth Intensive Care 2012; 40: 131-136, Department of Neurology, Selçuk University, Selçuklu Medical Faculty, Konya, Turkey, https://journals.sagepub. com/doi/pdf/10.1177/0310057X1204000115.
7. Phuping Akavipat, (2009), Endorsement of the FOUR score for consciousness assessment in neurosurgical patients, Neurol Med Chir (Tokyo), Vol. 49, pp. 565-571, Department of Anesthesiology, Prasat Neurological Institute, Bangkok, Thailand, PMID: 20035130, DOI: 10.2176/nmc.49.565, https://pubmed.ncbi. nlm.nih.gov/20035130/
8. Luis A. Idrovo Freire, (2011), The FOUR score: Is it just another new coma scale?, Intern Emerg Med (2012), No. 7, pp. 203–204, University of Leeds, Neurology Department and Neurosonology Laboratory, Hospital La Zarzuela and Hospital Nuestra Sra. Del Rosario, Madrid, Spain, DOI: 10.1007/s11739- 011-0640-5, https://www.researchgate.net/ publication/51188445.
9. Sharath S. Nair, Anilkumar Surendran, Rajmohan B. Prabhakar, Meer M. Chisthi (2017), Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study, International surgery journal, Vol. 4, No. 2, (2017), Department of of Surgical Oncology, Regional Cancer Center, Trivandrum, Kerala, India. pISSN 2349- 3305 eISSN 2349-2902, DOI: http://dx.doi. org/10.18203/2349-2902.isj20170209, https:// www.ijsurgery.com/index.php/isj/article/ view/975.
10. Parisa Ghelichkhani, Maryam Esmaeili, Mostafa Hosseini and Khatereh Seylani, (2018) department of Intensive Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. PMCID: PMC6289152 https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC6289152/
11. Juan Peng et. al., (2015), https://link.springer. com/article/10.1186/s12883-015-0508-9.
12. From Wikipedia, the free encyclopedia, https://en.wikipedia.org/wiki/FOUR_score.
13. Craig R Ainsworth, John geibel (2015) https:// emedicine.medscape.com/article/433855- overview.
14. Y. Kocak, S. Ozturk, F. Ege, A. H. Ekmekci, (2012) A useful new coma scale in acute stroke patients: FOUR score, Anaesth Intensive Care 2012; 40: 131-136, Department of Neurology, Selçuk University, Selçuklu Medical Faculty, Konya, Turkey, https://journals.sagepub. com/doi/pdf/10.1177/0310057X1204000115
Data Sharing Statement
"There are no additional data available. All raw data and code are available upon request."
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval."
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
The authors report no conflicts of interest in this work.
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Cite this article
Malha Ashok Nagre, Manorama Kashyap, Donit John. A descriptive Study to assess the Knowledge and
Knowledge Related to Practice Regarding Four Score Scale among Staff Nurses Working in ICU at Selected
Hospitals, with a view to Prepare Planned Teaching Programme. Int J Practical Nurs. 2026; 14(1): 07-16.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.