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Belay YH, Gezahegn D, Melaku B, Adal O. Nurses' competency on electrocardiography interpretation in adult emergency room: Addis Ababa, Ethiopia, 2021. Multicenter cross-sectional study. Int Emerg Nurs 2024; 74:101453. [PMID: 38678683 DOI: 10.1016/j.ienj.2024.101453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/26/2024] [Accepted: 04/06/2024] [Indexed: 05/01/2024]
Abstract
AIM This study aimed to assess the proficiency of nurses in interpreting electrocardiogram within the adult emergency units of Addis Ababa, Ethiopia, during the year 2021. METHODS This institutional-based descriptive, cross-sectional study involved 175 nurses from five randomly selected hospitals' adult emergency units. Semi-structured, self-administered questionnaires were used for data collection. Data were entered into Epi-Data and analyzed using SPSS version 26. Fisher's exact test identified statistical significance between dependent and independent variables at a p-value < 0.05. RESULTS Out of 203 respondents, 175 participated actively, yielding a response rate of 86.2%. Among these nurses, 159 (90.9%) were deemed not competent (scoring < 65%), with a mean score of 6.82 ± 3.65 SD. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was included in this study. CONCLUSION The overall competency level in electrocardiogram interpretation among nurses is significantly poor. This indicates that most nurses in the emergency units are unable to accurately interpret ECG monitoring, potentially leading to the failure to recognize signs of arrhythmias, electrolyte disturbances, and other cardiac abnormalities. Consequently, this may result in inappropriate patient care and increased mortality rates. Education and training were identified as key factors in enhancing their competency.
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Affiliation(s)
- Yegremew Haimanot Belay
- Department of Emergency Medicine & Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Demmelash Gezahegn
- Department of Emergency Medicine & Critical Care, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Birhanu Melaku
- Department of Emergency Medicine & Critical Care, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ousman Adal
- Department of Emergency Medicine & Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
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Alalwan MA, Alshammari T, Alawjan H, Alkhayat H, Alsaleh A, Alamri I, Aldubaikel A, Alqahtani J, Alrawashdeh A, Alqahtani S. Electrocardiographic interpretation by emergency medical services professionals in Saudi Arabia: A cross sectional study. PLoS One 2023; 18:e0292868. [PMID: 37856426 PMCID: PMC10586609 DOI: 10.1371/journal.pone.0292868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Management of acute myocardial infarction (AMI) and cardiac arrhythmias in prehospital settings is largely determined by providers of emergency medical services (EMS) who can proficiently interpret the electrocardiography (ECG). The aim of this study was to assess the ECG competency of EMS providers in Saudi Arabia. METHODS Between Aug and Sep 2022, we invited all EMS providers working for the Saudi Red Crescent Authority in Makkah, Riyadh, and Sharqiyah regions to complete a cross-sectional survey. The survey was used to assess the ability of EMS providers to interpret 12 ECG strips. Characteristics and ECG competency were summarized using descriptive statistics. Differences in ECG competency across paramedics with lower and higher qualifications were assessed. RESULTS During the study period, 231 participants completed the survey, and all were included. The overall mean age was 33.4, and most participants were male (94.8%). Nearly half of the participants were paramedics with an associate degree and 46.4% were paramedics with higher degrees. The average rate of correct answers to the 12 ECG strips was 43.3% (95% CI: 35.4%, 51.3%). Atrial flutter, ventricular fibrillation, atrial fibrillation, 3rd degree heart block, and ventricular tachycardia were identified by 52.8%, 60.2%, 42.0%, 40.7%, and 49.4% of the participants, respectively. The strip with an AMI was identified by 41.1%, while a pathological Q wave and ventricular extrasystole were identified by 19.1% and 24.7%, respectively. Paramedics with higher qualifications were as 28.0%-61.0% more likely to correctly interpret the 12 ECG strips compared to those with an associate degree (p-value across all variables was ≤ 0.001). CONCLUSION While the majority of participants in our region were unable to correctly answer the 12 ECG questionnaire, paramedics with higher qualifications were. Our study indicates that there is a need for evidenced-based ECG curricula targeting different levels of EMS professionals.
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Affiliation(s)
- Mohammed Abdullah Alalwan
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Talal Alshammari
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan Alawjan
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan Alkhayat
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Alsaleh
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ibrahim Alamri
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alaa Aldubaikel
- Department of Academic Affairs and Training, Saudi Red Crescent Authority, Dammam, Saudi Arabia
| | - Jaber Alqahtani
- Department of Respiratory Care, Prince Sultan Military College for Health Sciences, Dhahran, Saudi Arabia
| | - Ahmad Alrawashdeh
- Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saeed Alqahtani
- Department of Emergency Medical Services, Prince Sultan Military College for Health Sciences, Dhahran, Saudi Arabia
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Elsheikh E, Alkhteeb N, Alamer A, Alarfaj MO, AlQarni G, Alsultan J. Medical Students' Competency and Confidence in Interpreting Electrocardiograms at King Faisal University, Al-Ahsa. Cureus 2023; 15:e46393. [PMID: 37927746 PMCID: PMC10620545 DOI: 10.7759/cureus.46393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Electrocardiography is a crucial emergency tool in the pre-hospital situation. It is a useful non-invasive diagnostic technique for quickly identifying various heart disorders. The clinical value of the electrocardiogram (ECG) depends on the clinician's ability to interpret the result of the ECG accurately. Aims This study aims to assess the competency as well as the confidence in the interpretation of ECG among medical students at King Faisal University, Al Ahsa, Saudi Arabia. Methods This cross-sectional study was conducted among medical students enrolled at King Faisal University. Four hundred and ten (410) medical students from all five years completed an electronic self-administered pre-validated questionnaire. The questionnaire includes basic demographic data and ECG strips to assess medical students' competency and confidence levels in interpreting each case. Results More than half of the medical students were considered to have low competency (56.1%) and confidence (59%) levels. Increased competency and confidence scores were associated with fifth-year medical students and those who learned more about ECG interpretation through teaching during clinical rotations. The majority of medical students correctly interpreted anterior MI (69.3%), ventricular tachycardia (65.6%), and supraventricular tachycardia (61.2%). On the other hand, most students were unable to correctly identify pacemaker ECG (19.8%), long QT (21.2%) and left bundle branch block (33.4%). Conclusion Medical students' competency and confidence in ECG interpretation seems to be lacking. Fifth-year medical students who learned more ECG skills through teaching during clinical rotations tended to be more competent and confident with their ECG interpretation skills.
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Affiliation(s)
- Eman Elsheikh
- Internal Medicine, College of Medicine, King Faisal University, Al-Ahsa, SAU
- Cardiology, College of Medicine, Tanta University, Tanta, EGY
| | | | - Aisha Alamer
- Internal Medicine, King Faisal University, Al-Ahsa, SAU
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Al Mousa AM, Alhubail FM, Almulhim M, AlBeladi BA, Almulhim NA, Almulhim AA, Algouf IA, Khan AS. Electrocardiogram Interpretation Competency of Medical Interns in Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e37557. [PMID: 37193433 PMCID: PMC10183095 DOI: 10.7759/cureus.37557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/18/2023] Open
Abstract
Objective To determine the competence of medical interns in Saudi Arabia in interpreting common ECG abnormalities, explore limitations, and facilitate solutions to the development of ECG interpretation skills in Saudi Arabia. Methods This cross-sectional study was conducted from 11 June 2022 to 3 November 2022 using the convenience stratified sampling technique among 373 medical interns (54.4% male and 45.6% female) in 15 medical colleges within Saudi Arabia. Results Almost all (91.7%) of the participants recognized the basic ECG elements, as they correctly identified normal ECG patterns. The most well-understood ECG pathologies were ventricular fibrillation, atrial fibrillation, and acute myocardial infarction, which were accurately interpreted by 69.2%, 67.8%, and 61.9% of the participants, respectively. The least understood ECG result was a pathological Q wave, which only 20.9% recognized. Most (63.5%) participants attributed their challenges in ECG interpretation to their inadequate training in college, and 57.4% of them stated that practical case-based training could best facilitate the improvement of their skills in ECG interpretation. Conclusion Most of the participants showed unsatisfactory performance in ECG interpretation. Despite their completion of advanced cardiac life support courses, their overall performance did not improve significantly. Most of them believed that their colleges did not adequately train them to read ECGs. Thus, a majority think case-based training is a key strategy for improving their ECG interpretation skills.
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Affiliation(s)
- Ali M Al Mousa
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Fatimah M Alhubail
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Mohannad Almulhim
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Baneen A AlBeladi
- Clinical Pharmacy Department, College of Clinical Pharmacy, King Faisal University, Alahsa, SAU
| | - Nasser A Almulhim
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Abdullah A Almulhim
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Ibtisam A Algouf
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Abdul Sattar Khan
- Family and Community Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
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Bdair IA. Electrocardiogram interpretation competency among undergraduate nursing students: A quasi-experimental study. Nurs Forum 2022; 57:1273-1280. [PMID: 35997263 DOI: 10.1111/nuf.12790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiac diseases are highly prevalent. Electrocardiogram (ECG) is a noninvasive, rapid, safe, and low-cost procedure that is commonly used by nurses in clinical settings to diagnose a variety of cardiac arrhythmia. However, there is a limited number of studies that have assessed nursing students' competencies in electrocardiogram interpretation in Saudi Arabia. This study aimed to assess the electrocardiogram interpretation competency among undergraduate nursing students and to evaluate the effectiveness of the electrocardiogram interpretation educational program. METHODS A quasi-experimental pre-post-test design was conducted. A pre-post-test self-administered standardized questionnaire was completed by a convenient sample of 79 nursing students who enrolled in an educational program. Data were analyzed using descriptive and inferential statistics with p < .05 was assumed. The study hypothesized that ECG competency scores of nursing students who are enrolled in an educational program will be higher in post-test than their pre-test scores. RESULTS The vast majority of students (96.2%) expressed their interest to enroll in more ECG training sessions. The study results showed that students' mean ECG interpretation competency was 4.16 (1.88) and 7.43 (2.38) in pre- and post-tests, respectively, with a statistical significance of p < .001. CONCLUSION Overall performance of nursing students was limited. Study results confirm the primary hypothesis that the educational program was effective in improving students' ECG interpretation competencies. More ECG contents and programs should be integrated into nursing curricula and more follow-up studies are recommended. This study highlighted the significance of equipping nursing students with ECG interpretation competencies through education and training to ensure safe practice.
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Affiliation(s)
- Izzeddin A Bdair
- Department of Nursing, Al-Ghad International Colleges for Applied Medical Sciences, Riyadh, KSA
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Amini K, Mirzaei A, Hosseini M, Zandian H, Azizpour I, Haghi Y. Assessment of electrocardiogram interpretation competency among healthcare professionals and students of Ardabil University of Medical Sciences: a multidisciplinary study. BMC MEDICAL EDUCATION 2022; 22:448. [PMID: 35681191 PMCID: PMC9179219 DOI: 10.1186/s12909-022-03518-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/03/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND Electrocardiogram (ECG) interpretation is a core clinical skill that helps to rapid diagnosis of potentially life-threatening diseases. Misinterpretation of the electrocardiogram can lead to inappropriate clinical decisions with adverse outcomes. The main aim of this survey was to assess the competency of electrocardiogram interpretation and related factors among healthcare professionals and students of Ardabil University of Medical Sciences. METHODS This descriptive cross-sectional study included 323 staff and students of Ardabil University of Medical Sciences in northwestern Iran. Data were collected randomly from November to January 1400 using the Badell-Coll ECG Interpretation Competency Questionnaire and analyzed using SPSS V.14. Statistical analysis included descriptive statistics, independent t-test, ANOVA, Pearson correlation coefficient and multiple linear regression. RESULTS The results showed that the mean and standard deviation of electrocardiogram interpretation competency of health professional staff and students was 5.13 ± 2.25 (maximum score = 10). The large number of participants wasn't able to identify normal sinus rhythm (n = 251, 77.3%), acute myocardial infarction (n = 206, 63.8%) and pathological Q waves (n = 201, 62.2%). The results of multiple linear regression showed that the variables of education level, self-assessment of electrocardiogram interpretation competence, work experience, and type of hospital were able to predict the competence of ECG interpretation in participants. CONCLUSIONS Our findings showed that the participants' level of electrocardiogram interpretation competency was low. Hence, regular, standard training and education are recommended. Also, managers and educators of the health system should consider the role of positive self-assessment and exposure to ECG interpretation in improving the competence of staff and students to interpret ECG.
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Affiliation(s)
- Keyvan Amini
- Department of Internal Medicine, School of Medicine. Fatemi Hospital, Ardabil University of Medical, Ardebil, Iran
| | - Alireza Mirzaei
- Students Research Committee, Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mirtohid Hosseini
- Department of Critical Care Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Guilan, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center , Ardabil University of Medical Sciences, Ardabil, Iran
| | - Islam Azizpour
- Students Research Committee, Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Yagoob Haghi
- Faculty of Medicine & Paramedical, Ardabil University of Medical Sciences, Ardabil, Iran
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Rahimpour M, Shahbazi S, Ghafourifard M, Gilani N, Breen C. Electrocardiogram interpretation competency among emergency nurses and emergency medical service (EMS) personnel: A cross-sectional and comparative descriptive study. Nurs Open 2021; 8:1712-1719. [PMID: 33611852 PMCID: PMC8186699 DOI: 10.1002/nop2.809] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/24/2020] [Accepted: 01/31/2021] [Indexed: 12/13/2022] Open
Abstract
AIMS The aim of this research study was to compare electrocardiogram (ECG) interpretation competency among emergency nurses and EMS personnel. DESIGN A cross-sectional comparative descriptive study design was used. METHODS This study recruited 170 participants (105 emergency nurses and 65 EMS personnel) in northwest of Iran. Data were collected during 2018 using ECG, an interpretation competency questionnaire and analysed using SPSS V.24 through independent t test, linear regression, Pearson and Spearman correlation coefficient. A statistical significance of p < .05 was assumed. RESULTS The study results showed a mean score of 6.65 ± 2.16 out of 10 for emergency nurses' and 4.87 ± 1.81 for EMS personnel ECG interpretation competency (p < .05). CONCLUSIONS Hospital emergency nurses were more qualified to interpret the ECG than the pre-hospital emergency medical personnel (p = .792 and β (SE)) = 0.22 (0.84). Active involvement in ECG interpretation and standard continued education are needed to develop and improve the emergency nurses and EMS personnel ECG interpretation competency.
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Affiliation(s)
- Maryam Rahimpour
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Shahbazi
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery and Clinical Research Development Unit, Sina Educational, Research and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mansour Ghafourifard
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Cathal Breen
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Ulster, UK
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