Acute Care Nurses' Arrhythmia Knowledge: Defining Competency

Abstract

Background: Most methods of evaluating arrhythmia knowledge acquisition are internally developed by nursing professional development practitioners and are institution specific. This approach has resulted in assessing nurses' minimal qualifications for rhythm recognition as defined by the facility but does not result in describing basic, intermediate, and advanced competency levels for practice. Method: This quantitative study with a convenience sample of 85 acute care nurses refined an instrument to assess varying levels of arrhythmia recognition competency for acute care nurses. Results: The final instrument, called the Cardiac Arrhythmia Recognition Tool (CART), consisted of 33 items divided into basic, intermediate, and advanced subscales, with an overall Cronbach's alpha of .84. Conclusion: This study significantly contributes to defining arrhythmia competency in nurses caring for electrocardiographically monitored patients. [ J Contin Educ Nurs. 2020;51(1):39–45.]

Competency in ECG Interpretation and Arrhythmias Management among Critical Care Nurses in Saudi Arabia: A Cross Sectional Study

“…Given that most of the nurses in this study had completed BLS (63.9%) or ACLS (48.6%) courses, it is not surprising they can identify the asystole rhythm correctly and know how it should be managed. This finding is congruent with other studies [ 29 , 38 , 40 ]. In addition, the current study found nurses had difficulties identifying atrial flutter (58.4%), atrial fibrillation (50.2%), and third-degree complete heart block (56.9%).…”

Nurses’ competency in electrocardiogram interpretation in acute care settings: A systematic review

“…Cross‐sectional descriptive studies reported varying levels of nurses’ knowledge of ECG interpretation. For example, one quantitative study that looked at arrhythmia recognition competency for acute care nurses showed that 96% of nurses correctly identified atrial fibrillation and 95% ventricular tachycardia (Keller et al, 2020). By comparison, 71% of ambulance nurses in a prospective quantitative survey correctly identified atrial fibrillation and 35% ventricular tachycardia (Werner et al, 2016).…”

“…A positive relationship was demonstrated between professional factors (exposure, confidence, comfort or perception) and competency in ECG interpretation. Two quantitative studies reported the amount of exposure to ECG interpretation directly related to nurses’ abilities to interpret ECGs (Keller et al, 2020; VanArsdale, 1998). One qualitative study discussed ‘Use it or lose it’, illustrating the importance of nurses’ continued exposure to ECG interpretation (Nickasch, 2016).…”

“…Competency, used interchangeably with the terms of competence and competencies, was mostly defined as a knowledge of ECG interpretation in the included studies (Brooks et al, 2016; Goodridge et al, 2013; Keller et al, 2020; Keller & Raines, 2005; Kremser & Lyneham, 2007; Throndson & Davis, 2015). A recent scoping review exploring health frameworks recommends consistent use of the term ‘competency’, defined as the observable ability of a person who integrates knowledge, skills and attitudes in the performance of tasks (Mills et al, 2020).…”

“…There are many tools identified in this review that measured nurses’ competency in ECG interpretation. However, none of the tools encompass all three domains of competency assessment, namely knowledge, skills and attitudes (Brooks et al, 2016; Goodridge et al, 2013; Keller et al, 2020). This is similar to other assessment tools that evaluated nurses’ competency in their nursing roles.…”