Concussion: Why Nurses Need to Understand This Hidden Injury

Ann Worley


Pediatr Nurs. 2019;45(5):235-243. 

In This Article

Nurses' Knowledge Gaps: Review of Literature

Because nurses are often among the first clinicians a concussed child encounters in an emergency facility, a primary care, or a school office setting, they are in a unique position in determining the outcome of a child exhibiting symptoms. Yet despite media publicity about concussions over the past decade, many nurses, even pediatric nurses, demonstrate knowledge deficiencies. A study of 25 trauma nurses in a large pediatric hospital revealed pediatric-specific knowledge gaps and lack of confidence in concussion assessment and management including failure to understand when a previously discharged patient should return to the ED (Cook et al., 2013). Another study of 145 pediatric primary and emergency care providers in a large pediatric network indicated failure to recognize subtle concussion signs, such as abnormal eye tracking, vestibular disturbance, and sensitivity to noise/light (Zonfrillo et al., 2012). Additionally, a study by Watts and colleagues (2011) revealed that only 25% of bedside nurses demonstrated adequate skills to accurately identify and assess mTBI patients, and only 10% felt sufficiently confident in their knowledge to provide concussion education.