O2081: Transforming Pediatric Cardiac ICU Nursing: A Physician-Led, Interdisciplinary Approach to Boosting Knowledge and Confidence

Background: The Pediatric Cardiac ICU (PCICU) is a complex, high acuity environment. Registered Nurses (RN) are critical to successful outcomes with literature demonstrating improved patient outcomes in units with a higher percentage of experienced RNs. However, advanced RN training is not a pre-requisite to working in a PCICU and experience is often obtained over time. Our objective was to build a physician-led RN curriculum to enhance the knowledge and confidence of PCICU RNs, with hopes of creating a more experienced frontline.

Methods: The curriculum was developed within the framework of Kern’s 6 steps. A targeted needs assessment via survey was completed which identified respiratory physiology and ventilator management as a topic of need. Single session didactic and simulation content was developed and taught by a pediatric cardiac intensivist utilizing the Pediatric Cardiac Intensive Care Society (PCICS) Nurse Curriculum textbook. To assess the curriculum with regards to a modified Kirkpatrick’s framework we implemented a Likert Scale in response to 7 statements that assessed perception and perceived ability regarding concepts. The assessment was completed amongst all learners (n=117) with dedicated time post instruction. Measures of central tendency (mean, median, mode) were then assessed for interpretation. A 7-question pretest, posttest and 6-month delayed posttest was administered to learners to assess knowledge accumulation; 76 nurses completed all three tests. Scores were assessed via paired t-testing to determine significance and Cohen’s d test to assess effect size.

Results: Likert scale results indicated >95% of respondents felt more capable (agree or strongly agree) regarding all aspects of the curriculum; such statements include, "helped me to identify the increasing steps of respiratory support" and "helped me to understand cardiopulmonary interactions." Respondents (114/117) stated (agree or strongly agree) that they would want future sessions. Pretest, posttest and 6-month posttest regarding the curriculum was completed with scores (%, Mean +/- 95% CI): 46 +/- 5.8, 84 +/- 5.3, and 55 +/- 5.7 respectively. Paired t-testing indicated significant accumulation in knowledge when comparing pre vs posttest and pre vs 6-month posttest. Cohen’s d value was calculated using pretest vs 6-month posttest data and determined to be small-moderate with a value of 0.35.

Conclusion: Here we outline a physician-led PCICS based PCICU nurse curriculum, created via Kern’s 6 steps. RN perception of our curriculum was well received, and our data indicates knowledge acquisition and retention through 6 months. As indicated before, the PCICU is a complex environment, and RNs are critical to patient care with literature demonstrating improved outcomes with more experienced RNs. This highlights the importance of multidisciplinary investments in RN education. Next steps include further development of a multi-session longitudinal RN curriculum based on PCICS learning objectives.