Knowledge, attitude, and practice of Palestinian critical care nurses about hemodynamic instability in patients with cardiovascular diseases.

Abstract

Background: Managing hemodynamic instability in critically ill patients due to cardiovascular disease or, in particular, coronary artery disease requires an integrated and responsive approach. The complexity lies in simultaneously addressing the underlying cardiovascular pathology and managing its systemic effects. The complexity described above involves a careful balance of interventions, including fluid and electrolyte management, pharmacological support, and, in some cases, mechanical circulatory support. The dynamic nature of hemodynamic instability necessitates constant vigilance and rapid adaptation of treatment strategies to align with the evolving clinical picture. So, this study aims to investigate the knowledge, attitude, and practice of Palestinian critical care nurses about hemodynamic instability in patients with cardiovascular diseases.

Method: A cross-sectional design was conducted on 300 nurses in 30 hospitals in the West Bank and East Jerusalem of Palestine. Data were collected using a self-administered questionnaire composed of four sections covering the socio-demographics, knowledge, attitudes, and practices of the sample. Quantitative statistical analysis was done using Statistical Package for Social Sciences (SPSS) software.

Results: The nurses demonstrated an almost low overall level of knowledge about hemodynamic instability, with a mean score of 2.7 on a 7-points scale. Additionally, nurses generally expressed a high positive attitude toward their practice, with a mean score of 3.8 on a 5-point scale. Although; Palestinian nurses showed a low level of knowledge about hemodynamic instability but expressed positive attitudes toward their practice. The practice level was also moderate with a mean score of 2.3 on a 5-point scale. Significant differences were found with a higher attitude of male nurses and higher knowledge with bachelor or higher educational levels. Other variables showed non-significant differences.

Conclusions: Several challenges were identified, including lack of training and resources, within this study context. Educational interventions and improved access to resources could improve nurses' knowledge and practice in managing hemodynamic instability.