ICU护士心电图判读的实践与信心：一项横断面研究

摘要(中文译文)

本研究旨在了解中国福建省重症监护病房(ICU)护士对心电图(ECG)判读的实践情况和信心水平，并识别心电图判读实践的预测因素。本研究于2021年10月至2021年12月期间开展了一项定量横断面研究，共纳入357名调查对象。研究通过在线方式在福建省全部九个城市的二十一家医院进行。医院和调查对象分别采用目的抽样和方便抽样技术选取。数据收集使用经过验证和预测试的中文版问卷。我们采用二元logistic回归分析识别ICU护士心电图判读实践的预测因素，并采用线性回归分析心电图判读实践与信心之间的关系。我们将p值<0.05视为具有统计学意义。调查对象实践得分的平均分为5.54分(SD=2.26)，满分为10分，仅2.2%的护士能够正确判读所有患者心电图条带。少数ICU护士(25.5%)具有良好的心电图判读实践，其判读患者心电图条带总体能力的信心平均得分为2.02分(SD=0.99)，满分为4分。与心脏ICU相比，当前工作单元(急诊ICU：AOR=5.71，95%CI：1.84-17.75)；既往心电图培训经历(AOR=2.02，95%CI：1.10-3.70)；心电图培训来源(大学/学校)(AOR=2.02，95%CI：1.12-3.65)；以及心电图知识(AOR=16.18，95%CI：7.43-35.25)与心电图判读实践显著相关。本研究中ICU护士的心电图判读实践相对较差。建议开展心电图教育项目，向ICU护士传授基本心电图知识，以促进良好的心电图判读实践并增强护理服务提供中的信心。良好的心电图判读技能对ICU护士而言至关重要，有助于改善患者结局。ICU护士的心电图知识是有效进行心律失常心电图监测的重要预测因素。因此，需要频繁、持续的良好实践并增强信心，以提供优质护理服务。

Abstract

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. A quantitative cross-sectional study was conducted between October 2021 and December 2021 among 357 respondents. Conducted online at twenty-one hospitals in all nine cities of Fujian Province. 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. 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. 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. 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.

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