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Associations Between Perceived Knowledge, Interprofessional Collaboration, Autonomy and the Frequency of Nursing
Semyon Melnikov1, Reem Abed Elhai2, Nashaat Hijazi3
1Department of Nursing Sciences, Steyer School of Health Professions, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Background:
Extracorporeal membrane oxygenation (ECMO) requires coordinated multidisciplinary care. Although registered nurses (RNs) play a critical role, evidence on factors associated with the frequency of ECMO-related nursing activities in paediatric settings remains limited.
Aim:
To examine associations between perceived ECMO knowledge, interprofessional collaboration, nursing autonomy and the frequency of ECMO-related nursing activities.
Study Design:
A multicentre cross-sectional study was conducted. RNs completed questionnaires assessing perceived ECMO knowledge, autonomy, interprofessional collaboration and ECMO-related nursing activities. Data were analysed using bivariate correlations and multivariable linear regression models.
Results:
A convenience sample of 83 RNs from four Israeli paediatric intensive care units (median age 36 years (IQR 31-43), 84% female) participated in the study. In bivariate analyses, nursing autonomy was positively correlated with total ECMO nursing activities (Spearman's rs = 0.34, p < 0.01), while interprofessional collaboration was also positively associated (rs = 0.32, p < 0.01). In multivariable analyses, nursing autonomy was associated with greater involvement in administering medication and blood products through the ECMO circuit (B = 0.50, 95% CI [0.21, 0.80], p < 0.001), while perceived ECMO knowledge was associated with greater involvement in device calibration and monitoring (B = 0.39, 95% CI [0.13, 0.64], p = 0.004). RN-perfusionist teamwork was negatively associated with medication and blood administration through the ECMO circuit (B = -0.29, 95% CI [-0.50, -0.08], p = 0.008).
Conclusions:
The frequency of nursing activities in paediatric ECMO care is associated with both individual-level factors (knowledge and autonomy) and interprofessional dynamics. Targeted education and training aimed at enhancing ECMO-related knowledge, nursing autonomy and interprofessional collaboration may support RNs' participation in ECMO-related nursing activities.
Relevance To Clinical Practice:
ECMO-specific education, clear role delineation and effective interprofessional collaboration may enhance RNs' participation in paediatric ECMO care.
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