ICU Nurses' Proficiency in Recognising Patient-Ventilator Asynchrony: A Cross-Sectional Study.

Background: Patient-ventilator asynchrony (PVA) is a prevalent complication in mechanically ventilated patients, leading to delays in weaning, prolonged ICU stays and increased mortality. Ventilator waveform analysis, a non-invasive and reliable diagnostic method, is essential for detecting PVA. However, its accuracy relies heavily on the interpretive skills of healthcare providers.

Aim: This study aimed to assess the ability of ICU nurses to recognise PVA using ventilator waveforms and examined the influence of gender, clinical experience and mechanical ventilation-related training on their recognition performance.

Study design: A cross-sectional survey was conducted from November 2023 to April 2024 at seven tertiary hospital ICUs in four regions of China. A standardised questionnaire was used to collect demographic, clinical experience and training information. The recognition ability of nurses was evaluated based on their ability to identify six common PVA types through nine ventilator waveform images, with a maximum score of 9.

Results: A total of 168 out of 195 eligible ICU nurses completed the survey, resulting in a response rate of 86.15%. The overall PVA recognition ability among ICU nurses was low, with a mean score of 4.6. Male nurses had significantly higher scores than female nurses. Nurses with < 5 years of ICU experience had lower scores compared to those with 5-10 years and > 10 years of experience. There was no significant difference between the 5-10 years and > 10 years groups (p = 0.25). Nurses who received mechanical ventilation-related training scored significantly higher than untrained nurses. Among the trained nurses, those with > 100 h of training performed better than those with ≤ 100 h. Gender differences were no longer significant after training (p > 0.05).

Conclusions: Specialised training in mechanical ventilation significantly improved ICU nurses' ability to recognise PVA. This training bridged gaps related to gender and clinical experience, enhancing the recognition skills necessary for effective mechanical ventilation management.

Relevance to clinical practice: The ability of ICU nurses to accurately recognise PVA through ventilator waveform analysis is crucial for improving patient outcomes and the quality of care for mechanically ventilated patients. Training programmes should incorporate ventilator waveform interpretation to improve recognition and management of PVA.