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Nurses' Competence Caring for Hospitalized Patients With Ventricular Assist Devices
Jesus M Casida1, Martha Abshire, Brian Widmar
1Jesus M. Casida, PhD, RN, APN-C, is a faculty associate at Johns Hopkins University, Baltimore, Maryland. His program of research focuses on the self-management of patients with VADs. Martha Abshire, PhD, RN, is an assistant professor at the Johns Hopkins School of Nursing, Baltimore, Maryland. Her research focuses on improving psychosocial outcomes for patients and caregivers managing advanced heart failure. Brian Widmar, PhD, RN, ACNP-BC, is assistant professor and director of the Adult-Gerontology Acute Care Nurse Practitioner program at Vanderbilt University School of Nursing, Nashville, Tennessee. He is also an acute care nurse practitioner in the Heart Transplant Program at Vanderbilt University Medical Center. Pamela Combs, PhD, RN, is internationally known for her leadership and expertise in the management of patients with VADs. Currently, she is clinical research nurse at the University of Chicago's Department of Cardiac Surgery, Illinois. Regi Freeman, MSN, RN, ACNS-BC, is a board-certified adult health clinical nurse specialist in the cardiovascular intensive care unit (CVICU) at Michigan Medicine, Ann Arbor. The CVICU is a 32-bed high-acuity intensive care unit caring for complex surgical procedures, mechanical circulatory support, and extracorporeal membrane oxygenation. Ms Freeman has published multiple articles and also presented nationally. Linda Baas, PhD, RN, is professor emeritus at the University of Cincinnati College of Nursing, Ohio. She served as president of the American Association of Heart Failure Nurses in 2012-2013.
Background:
Nursing care is an essential component of the delivery of high-quality patient care for advanced heart failure patients with ventricular assist devices (VADs). However, there is little information about how VAD patient care competence is formed, and there are no empirical data regarding the bed nurses' competence.
Objectives:
The aim of this study was to explain how nurses perceived their competence related to VAD technology and how they utilized resources to equip themselves for the management of patients with implantable VADs.
Methods:
An exploratory correlational research design was used in this study. Online surveys including demographic and work characteristics questionnaires as well as VAD Innovation in Nursing Appraisal Scale (knowledge, adoption, and communication) were completed by 237 critical-care unit and progressive care unit (PCU) nurses.
Results:
Ventricular assist device knowledge, adoption, and communication of innovation mean scores were 3.9 ± 0.6, 3.9 ± 0.8, and 3.7 ± 0.9, respectively, indicating moderate/high levels. Critical-care unit nurses reported higher levels of knowledge (3.7 vs 3.6) and adoption (4.0 vs 3.8; P < .05) of innovation than did the PCU nurses, with no differences in communication. Compared with PCU nurses, critical-care unit nurses were more likely to seek VAD competence-related information using mass media. Innovation and adoption were associated with years of nursing experience and some hospital characteristics.
Conclusion:
Critical-care unit nurses have higher self-reported VAD care competence than PCU nurses. Further research is needed to confirm the findings and link nurse competence with VAD patient outcomes.