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重症监护病房护士心电图解读的实践与信心:一项横断面研究。

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

作者信息

Buluba Salome E, He Jinyi, Li Hong

机构信息

School of Nursing, Fujian Medical University, Fujian, China; Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Department of Cardiovascular Surgery, Fujian Provincial Hospital, Fujian, China; School of Public Health, Fujian Medical University, Fujian, China.

出版信息

Intensive Crit Care Nurs. 2025 Feb;86:103835. doi: 10.1016/j.iccn.2024.103835. Epub 2024 Sep 18.

Abstract

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.

摘要

目的

本研究旨在确定中国福建省重症监护病房(ICU)护士心电图解读的实践情况与信心,并确定心电图解读实践的预测因素。

研究方法/设计:2021年10月至2021年12月对357名受访者进行了一项定量横断面研究。

研究地点

在福建省九个城市的21家医院在线开展。

主要结局指标

分别采用立意抽样和便利抽样技术选取医院和受访者。数据收集采用经过验证和预测试的中文版问卷。我们进行二元逻辑回归以确定ICU护士心电图解读实践的预测因素,并进行线性回归以分析心电图解读实践与信心之间的关系。我们认为p值<0.05具有统计学意义。

结果

受访者的实践平均得分为5.54分(标准差=2.26)(满分10分),只有2.2%的护士能正确解读所有患者的心电图条带。很少有ICU护士(25.5%)有良好的心电图解读实践,在解读患者心电图条带的总体能力方面,信心平均得分为2.02分(标准差=0.99)(满分4分)。与心脏ICU相比,目前的工作单位(急诊ICU:比值比=5.71,95%置信区间:1.84-17.75);以前接受过心电图培训(比值比=2.02,95%置信区间:1.10-3.70);心电图培训来源(大学/学校)(比值比=2.02,95%置信区间:1.12-3.65);以及心电图知识(比值比=16.18,95%置信区间:7.43-35.25)与心电图解读实践显著相关。

结论

本研究中ICU护士的心电图解读实践相对较差。建议开展心电图教育项目,向ICU护士传授基本的心电图知识,以加强良好的心电图解读实践及提供护理服务的信心。

对临床实践的启示

良好的心电图解读技能对ICU护士至关重要,有助于改善患者预后。ICU护士的心电图知识是有效监测心律失常心电图的重要预测因素。因此,应经常、持续地进行良好实践并增强提供优质护理服务的信心。

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