Electrocardiograms: a guide to rhythm recognition for emergency nurses

Standard practices in cardiac monitoring: training needs of intensive care unit nurses

BACKGROUND

Enforcing practice standards for cardiac monitoring in intensive care units (ICUs) has been shown to reduce misdiagnoses and inappropriate interventions. Continuous professional development (CPD) programs are committed to aligning clinical practices with recommended standards. The crucial initial phase in CPD development involves assessing the training needs of the targeted population.

OBJECTIVE

To assess the training needs of ICU nurses in cardiac monitoring. The overarching goal was to formulate a focused Continuous Professional Development (CPD) program geared towards implementing standard practices in cardiac monitoring.

METHODS

This study employed a generic qualitative approach with a descriptive design, utilizing interviews and focus groups from July to September 2018. Involving 16 ICU nurses. Content analysis was employed, encompassing transcription, fluctuant and iterative reading, unitization, categorization, coding, description, and interpretation.

RESULTS

All nurses recognized cardiac monitoring's importance in the ICU but reported barriers to its effective implementation which were related to factors that could addressed by a CPD as insufficient knowledge and skills. Training needs were identified in both clinical and technical aspects, with recommendations for practical and theoretical activities and e-learning strategies. Barriers related to organizational aspects (equipment and communication within the healthcare team) were also mentioned.

CONCLUSION

ICU nurses presented clear and specific training needs related to cardiac monitoring as knowledge, skills, and competencies. Other organizational aspects were also reported as barriers. Addressing these learning needs through targeted CPD aligned with organizational initiatives can contribute to enhancing the quality of cardiac monitoring practices in ICUs.

Assessing the Level of Electrocardiographic Interpretation Competency among Emergency Nurses in Palestine

Introduction

The use of electrocardiograms (ECGs) is widespread among emergency room (ER) nurses for diagnosis and triage, making it crucial for them to have the appropriate level of competency in interpreting ECGs. This can lead to better healthcare and patient outcomes.

Objectives

This study aims to assess the competency level of emergency nurses in Palestine in interpreting normal ECG and certain cardiac arrhythmias, and to explore the association between socio-demographic characteristics and their ECG interpretation competency.

Methods

The study used a cross-sectional descriptive design, and 196 ER nurses were conveniently recruited to fill out a self-administered questionnaire based on previous literature. The data collected were analyzed using SPSS with strict adherence to ethical considerations.

Results

The results showed that 70.9% of the nurses were males, 65.3% held a bachelor's degree in nursing, 46.9% had 1-5 years of experience, and 60.7% had received previous courses on ECG interpretation. The mean competency level of the ER nurses was satisfactory at 60.714%, but 38.8% had a poor level of competency. This was significantly higher among nurses with higher educational levels (p-value < 0.001), those who had taken previous ECG courses (p-value = 0.045) and life support (p-value < 0.05), and those who were exposed to more ECG interpretations per day (p-value = 0.001).

Conclusion

There is a need to focus more on ECG competency levels in Palestinian literature and compare them between different departments. It is also essential to evaluate nurses' needs for continuous education.

Electrocardiogram interpretation competency among emergency nurses and emergency medical service (EMS) personnel: A cross-sectional and comparative descriptive study

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.

Capability of emergency nurses for electrocardiogram interpretation

INTRODUCTION

Electrocardiogram is the first-line diagnostic imaging modality for evaluating patients with chest pain. The present study aimed to determine the capability of emergency nurses for electrocardiogram interpretation by using a more appropriate questioning method.

METHODS

This was a cross-sectional descriptive survey. A convenience sample of 96 emergency nurses was obtained from two emergency departments in Hong Kong. The electrocardiogram-interpretation capability of the emergency nurses was determined using a self-developed well-designed questionnaire comprising 10 questions on electrocardiogram interpretation. Each question carried one point, such that the maximum score was 10 points. The higher the score, the more capable was the emergency nurse at electrocardiogram interpretation.

RESULTS

The mean score achieved by the participants was 7.7 ± 1.8. Only 12.5% of the participants were able to answer all questions correctly. A considerable proportion of the participants were unable to recognize first-degree heart block (74.0%), second-degree heart block type I (52.1%), or third-degree heart block (39.6%). Gender, electrocardiogram training, nursing experience, and emergency department experience had significant associations with mean score.

CONCLUSIONS

The electrocardiogram-interpretation capability of the emergency nurses was fair. Better training should be implemented to help emergency nurses recognize potentially fatal heart blocks, enabling prompt and appropriate patient treatment.