Staffing and Organisation of Nursing Care in Cardiac Intensive Care Units in Greece

PURPOSE: To explore staffing and organisational characteristics of nursing care in cardiac intensive care units (CICUs) in Greece. METHODOLOGY: An exploratory descriptive survey design with additional cross-sectional comparisons was employed. A specifically developed survey-type questionnaire, addressed to nurse managers, was distributed to all CICUs in Greece. RESULTS: The response rate was 76.2% (N=32 units). Nursing staff per bed ratios over 24 h (whole-time equivalent) were very low and exhibited a mean of 1.25 (+/-0.53). The total registered nurse to assistance nurse (RN/AN) ratio was 2.74, but a lot of variability was observed and in many units ANs operated in RNs positions. Only 42% of the nurses had participated at in-service continuing education programs and a systematic training program in cardio pulmonary resuscitation (CPR) was provided in only 12 (37.5%) units. The reported frequencies at which specific technical tasks were performed autonomously by nurses varied substantially and reflected a medium to low level of practice autonomy; the most frequently reported tasks were: peripheral IV line insertion, CPR chest compression, titration of vasoactive drugs and administration of analgesics. Higher percentages of nurses had received in-service training associated with the likelihood of performance of several technical tasks (P<0.03). CONCLUSIONS: Future studies need to explore the effect of these organisational characteristics on patient outcomes. The endorsement of nation-wide standards for nursing staffing and training in CICUs is imperative.