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Perceived Competence and Educational Gaps in ECMO Nursing: A Multicenter Cross-Sectional Survey in Italy
Giovanni Gazzeri1, Riccardo C Piccione2, Chiara Gentini1
1Intensive Care Unit and ECMO Center, Careggi Teaching Hospital, Florence.
Objectives:
To evaluate the perceived competence, clinical experience and training needs of Italian nurses involved in ECMO patient care.
Methods:
A cross-sectional survey was conducted in 12 accredited ECMO centers across Italy, targeting ICU nurses with at least 6 months of ECMO experience. The questionnaire assessed perceived competence, procedural exposure, emergency preparedness, nontechnical skills, and training background.
Results:
Among 162 respondents, most reported adequate perceived competence regarding ECMO indications and monitoring. However, practical experience with procedures such as cannulation, circuit change, and interhospital transfer was limited. Confidence in managing emergencies without immediate perfusionist support was low. Preferred training modalities included simulation and on-the-job coaching. Nontechnical skills such as teamwork and critical thinking were widely recognized as essential.
Conclusions:
The study reveals a substantial gap between perceived theoretical competence and practical readiness among ECMO nurses in Italy. Training variability and lack of formal curricular structures contribute to limited preparedness, especially for emergency management.
Implications For Clinical Practice:
Standardized, simulation-based training programs should be implemented nationally to improve ECMO nursing competence, focusing on emergency scenarios and nontechnical skills. Establishing certification pathways may enhance professional recognition and safety in ECMO care.