Effects of educational intervention on knowledge of Full Outline of Un Responsiveness score among health workers in uganda: a quasi -experimental pilot study

Abstract

Background: The Full Outline of Un-Responsiveness (FOUR) score is a new and better coma grading scale in critically ill patients. However, there is a paucity of data on its knowledge among health workers in sub-Saharan Africa. This study assessed the effects of an educational intervention on knowledge of FOUR Score among health workers at a Regional Referral Hospital in Southwestern Uganda. Methods: This was a one-group quasi-experimental study among conveniently sampled health workers attending to critically ill patients. Using a pretested questionnaire, data was collected pre and post intervention. Participants with low and moderate pre-test knowledge attended a theory session of 45-minutes and hands on sessions using the FOUR Score reference chart for one week, on ward. The post-test data was collected for all trained participants seven days after training. Data was analysed using STATA-17. Results: Of the 146 health workers (HWs) recruited, 50.7% and 45.2% were nurses and doctors, respectively. Over 113 (77.0%) were degree holders and 114 (78.1%) had no prior FOUR Score training. The median knowledge score was 8 (34.8%) and 19 (82.6%) in the pre- and post-test, respectively. A Wilcoxon Signed-Rank test showed a significant knowledge score difference in the median pre- and post-test (Z=10.4; p<0.001). Higher level of education (X2 [1]=10.3, P=0.016), working in ICU (X2 [2]=13.8, P=0.001), and prior FOUR Score training (Z=6.3, P<0.001) were significantly associated with high pre-test knowledge score but were not significant in the post-test. Conclusion: This educational intervention was effective in increasing the knowledge of health workers regarding the FOUR score, indicating that it can be easily learned and mastered. When properly done, this intervention could potentially improve the management of critically ill patient in similar (low- and middle-income countries) settings.