Practice and confidence in electrocardiogram interpretation among ICU nurses: A cross-sectional study

Objectives

This study aimed to determine practice and confidence in electrocardiogram (ECG) interpretation among intensive care unit (ICU) nurses in Fujian Province, China, and identify predictors of ECG interpretation practice.

Research methodology/design

A quantitative cross-sectional study was conducted between October 2021 and December 2021 among 357 respondents.

Setting

Conducted online at twenty-one hospitals in all nine cities of Fujian Province.

Main outcome measures

Purposive and convenient sampling techniques were employed in selecting hospitals and respondents, respectively. A validated and pre-tested Chinese version of the questionnaire was used in data collection. We conducted binary logistic regression to identify the predictors of ICU nurses’ ECG interpretation practice, and linear regression to analyze the relationship between ECG interpretation practice and confidence. We considered statistically significant a p-value < 0.05.

Results

The practice mean score of the respondents was 5.54 (SD = 2.26) out of 10 points, and only 2.2 % of nurses correctly interpreted all the patient ECG strips. Few ICU nurses (25.5 %) had good ECG interpretation practice, with a confidence mean score of 2.02 (SD = 0.99) out of 4 points in their overall ability to interpret patient ECG strips. Currently working unit in comparison to cardiac ICU (emergency ICU: AOR = 5.71, 95 % CI: 1.84–17.75); previous ECG training (AOR = 2.02, 95 % CI: 1.10–3.70); source of ECG training (university/school) (AOR = 2.02, 95 % CI: 1.12–3.65); and ECG knowledge (AOR = 16.18, 95 % CI: 7.43–35.25) were significantly associated with the ECG interpretation practice.

Conclusions

ICU nurses’ ECG interpretation practice in the current study was relatively poor. An ECG education program is recommended to impart ICU nurses with basic ECG knowledge for enhancing good ECG interpretation practice and confidence in nursing care provision.

Implications for clinical practice

Good ECG interpretation skills are paramount among ICU nurses for better patient outcomes. ECG knowledge among ICU nurses is an important predictor of effective ECG monitoring for cardiac arrhythmias. Therefore, frequent, continuouszgood practice and boost confidence in the provision of quality nursing care.