Contemporary structures, processes, and outcomes of critical care nursing education: An integrative review

The critical care workforce requires nurses who are specialised, educated, and adaptable to manage complex situations, with the capability to make informed decisions for optimal patient care. The Australian College of Critical Care Nurses supports evidence-based practice through an education position statement, which is periodically updated to reflect evolving needs. In this review, our aim was to inform revisions to the position statement on critical care nurse education by examining the structure, processes, and outcomes of contemporary education programs designed to enhance the capability of registered nurses working in critical care environments internationally.

An integrative review was conducted using Whittemore and Knafl's framework.

Data were collected from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Medline, Embase, Emcare, Joanna Briggs Institute, and Google Scholar from January 2017 to the end of December 2024.

Articles were included if they were peer reviewed, published in the English language, and focused on education programs for critical care nurses. Data extraction and quality appraisal were performed using appropriate tools.

A total of 35 papers were included, revealing significant variations in the structure of critical care nursing education programs. Key facilitating processes were diverse delivery methods (online, face-to-face, and hybrid), structured curricula, and infrastructure (digital tools, human, and support systems). Positive outcomes included developing capability; improved patient outcomes; enhanced confidence, competence, and clinical performance; advanced communication skills; and leadership confidence to assume a decisional role. However, a lack of a standardised tiered education framework was observed.

The findings indicate significant variations in the structure of critical care nursing education programs, emphasising the need for a standardised tiered framework to ensure consistent theoretical underpinning and skill levels, leading to improved patient outcomes and the transferability of qualifications. The review advocates for technologically integrated, culturally safe, and flexible education programs that support the development of advanced practice critical care knowledge and capabilities.

This review has been registered with the Open Science Framework Registry (10.17605/OSF.IO/9QYDH).