• conscious level assessment;
  • intensive care;
  • nursing

Aim  To identify factors that have an impact on nurses’ performance of patients’ conscious level assessment.

Background  There is a need for nurses to accurately assess a patient’s conscious level to detect neurological changes and initiate prompt action.

Methods  Nine databases were systematically searched (1990–February 2010) to review experimental, cohort, case control, cross-sectional and descriptive studies that addressed factors which affected nurses’ performance of patient conscious level assessment. Participants in the studies reviewed were nursing staff. The Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument was used for quality assessment.

Results  Eleven studies were analysed in this review. Knowledge and experience were found to be the most significant factors in determining nurses’ performance of patient conscious level assessment. Formal training was found to be effective in improving assessment skills and experience greatly affected the accuracy of assessment.

Conclusion  Knowledge and experience are the most significant factors on nurses’ performance of consciousness level assessment.

Implications for nursing management  Formal training is needed on a continual basis to maintain skills in consciousness level assessment, and nurses who are more experienced in the use of assessment should mentor those that are less experienced.