Staffing and organisation of nursing care in cardiac intensive care units in Greece.

Abstract

To explore staffing and organisational characteristics of nursing care in cardiac intensive care units (CICUs) in Greece. An exploratory descriptive survey design with additional cross-sectional comparisons was employed. A specifically developed survey-type questionnaire, addressed to nurse managers, was distributed to all CICUs in Greece. The response rate was 76.2% (N=32 units). Nursing staff per bed ratios over 24 h (whole-time equivalent) were very low and exhibited a mean of 1.25 (+/-0.53). The total registered nurse to assistance nurse (RN/AN) ratio was 2.74, but a lot of variability was observed and in many units ANs operated in RNs positions. Only 42% of the nurses had participated at in-service continuing education programs and a systematic training program in cardio pulmonary resuscitation (CPR) was provided in only 12 (37.5%) units. The reported frequencies at which specific technical tasks were performed autonomously by nurses varied substantially and reflected a medium to low level of practice autonomy; the most frequently reported tasks were: peripheral IV line insertion, CPR chest compression, titration of vasoactive drugs and administration of analgesics. Higher percentages of nurses had received in-service training associated with the likelihood of performance of several technical tasks (P<0.03). Future studies need to explore the effect of these organisational characteristics on patient outcomes. The endorsement of nation-wide standards for nursing staffing and training in CICUs is imperative.