Introduction: Critical care nursing (RN) experience is directly associated with inpatient clinical outcomes1,2 and has been negatively impacted by increased employment turnover since the COVID-19 pandemic.3 Identifying knowledge traditionally attained experientially for incorporation into curriculum may represent a solution. As the National Council Licensure Examination minimally covers concepts related to invasive mechanical ventilation (IMV)4, an essential component of intensive care unit (ICU) management, we aimed to characterize the experience level and observed/ self-reported IMV-related knowledge among pediatric ICU RNs and staff. Methods: We performed a mixed-methods observational cohort study at a quaternary pediatric referral center to estimate RN experience level, IMV knowledge, and confidence in managing pediatric IMV. Direct observation of day and night ICU work rounds paired with RN interviews were conducted between 4/1/2025-06/30/2025 to assess knowledge regarding patient-specific IMV parameters and management, shared IMV goals of care and anticipatory guidance, and RN experience (i.e., years out of training). Electronic surveys were completed by ICU staff (i.e., physicians, advanced practice providers, RNs, and respiratory therapists) evaluating respondent perceptions regarding RN IMV-related knowledge and confidence in management using parametric Likert scales. Results: Of 108 unique rounds encounters, 43% included a bedside RN with ≤2 years of experience. In post-rounds interviews, 48% of RNs correctly recalled their patients’ IMV settings (e.g., driving pressure, tidal volume, and rate) and 13% accurately recalled rounds-established IMV-related anticipatory guidance. Of 137 surveys completed (response rate 29%), 81 (51%) respondents were RNs. Only 9% of RNs with ≤2 years of experience reported moderate to extreme confidence in IMV management, compared to 87% of nurses with >2 years of experience. Of the 56 non-RN respondents, only 16.7% rated the bedside RNs’ knowledge of IMV as good or very good. Conclusions: Pediatric RNs with ≤2 years of experience made up a significant portion of the ICU workforce and were observed to have/ self-reported IMV knowledge deficits. These findings highlight an opportunity to develop targeted RN IMV curriculum.
Corrado et al. (Sun,) studied this question.