ICU nurses’ knowledge and attitude towards electrocardiogram interpretation in Fujian province, China: a cross-sectional study

Abstract

IntroductionThe series of electrocardiograms (ECGs) can help track cardiac abnormalities in patients’ conditions and make an earlier clinical decision. It is crucial for nurses working in critical care environments to acquire ECG knowledge for effective ECG monitoring and act accordingly in case of a change in patient condition. This study aimed at investigating intensive care unit (ICU) nurses’ knowledge and attitude towards ECG interpretation in Fujian province, China. The study also analyzed the relationship between participants’ demographic characteristics and level of ECG knowledge.MethodsThis study was done online at twenty-one hospitals in Fujian province using a quantitative cross-sectional design involving 357 registered nurses working in the ICU between October and December 2021. The selection of hospitals and potential participants involved purposive and convenient sampling methods, respectively. Binary logistic regression was carried out to determine factors that predict ICU nurses’ knowledge of ECG interpretation, and a p-value <0.05 was deemed statistically significant.ResultsThe majority of nurses (70.9%) demonstrated a low level of ECG knowledge. The mean score for ECG knowledge was 5.95 (SD = 2.14), with only 0.8% of ICU nurses answering all questions correctly. The majority portrayed positive attitude towards ECG interpretation; however, more than half (61.6%) believed that nurses should rely on a doctor’s opinion about ECG interpretation. Previous ECG training (AOR = 3.98, 95% CI: 2.12–7.45); frequency of ECG interpretation in comparison with no frequency of ECG interpretation (1–3 times per day: AOR = 15.55, 95% CI: 6.33–38.18; 1–3 times per week: AOR = 18.10, 95% CI: 6.38–51.34); and current working unit in comparison to those working in cardiac ICU (general ICU: AOR = 0.45, 95% CI: 0.21–0.94; medical ICU; AOR = 0.28, 95% CI: 0.12–0.67; and surgical ICU; AOR = 0.05, 95% CI: 0.01–0.43) remained statistically significant after adjusting for confounders.ConclusionThe present study revealed a low level of knowledge about ECG interpretation among ICU nurses. Although the participants demonstrated positive attitudes toward ECG interpretation, the negative attitude still existed. Nurses should acknowledge ECG interpretation as part of their duties and responsibilities in nursing care instead of merely relying on doctors’ opinions.

The Impact of Electrocardiogram Interpretation Training Program on Intern Nursing Students' Competencies: A Quasi-Experimental Study

“…This nding is in consistent with Shehab et al [20] who studied the effect of an educational program of electrocardiogram interpretation on medical and maternity nurses' knowledge and skills and found no statistically signi cant association between sociodemographic data of the study group and their total knowledge score throughout the educational program. However, another study was conducted by Buluba et al [4] and showed contradicting ndings where they indicated that all the demographics of the participants nurses showed signi cant association with the ECG knowledge level.…”

“…In con rmation of the researcher's point of view, Jablonover et al, reported that the level of competency in ECG interpretation was previously found to be correlated with the degree of ECG exposure [30]. According to Buluba et al, frequent exposure to ECG interpretation facilitates retention of knowledge [4]. As well, Chen et al documented that it is expected that low competency will be observed in ECG patterns that are less commonly encountered by students, and vice versa [18].…”

“…Additionally, this may have a negative impact on the patients, their families and hospital as result of missed interpretation of electrocardiogram (ECG). Nurses should acknowledge ECG interpretation as part of their duties and responsibilities in nursing care instead of merely relying on doctors' opinions [4].…”

“…ECG as one of the most frequently performed diagnostic procedure, requires accurate understanding especially in case of life-threatening scenarios, which can help track cardiac abnormalities and make an earlier clinical decision on appropriate actions and consequently may have an impact on the patients' health [4,5]. International guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) have demonstrated that the accurate and timely interpretation of cardiac arrhythmias fastens the identi cation of appropriate treatment and increases patient survival [6].…”

Advancing arrhythmia education through the CDIO approach: a new paradigm in nursing student training

“…Timely identification and management of life-threatening arrhythmias by nurses can reduce mortality rates and improve patient outcomes [ 12 ]. A study shows that most practicing nurses exhibit a positive attitude towards the diagnosis of arrhythmias, but the majority demonstrate a lower level of proficiency in arrhythmia diagnosis [ 13 ]. Another study found that nursing students have a certain gap compared to practicing nurses in both theoretical knowledge and practical skills [ 14 ].…”