Assessment of 12-Lead Electrocardiogram Interpretation Competency Among Critical Care Nurses: A Multi-Center Cross-Sectional Study in Public and Private Tertiary Care Hospitals of Peshawar, Pakistan

Abstract

Cardiovascular disease (CVD) is the leading cause of death globally and timely ECG interpretation by critical care nurses is vital for lowering mortality rates in clinical settings. In Pakistan, no evidence of a multi-center study exists that has comprehensively assessed nurses’ competency in ECG interpretation. The aim of this study is to assess the ECG interpretation competency among critical care nurses, to identify association between nurses’ demographics and their ECG interpretation skills, and to compare the competency level scores of nurses of public and private hospitals. A multi-center quantitative descriptive cross-sectional study was conducted across six tertiary care hospitals in Peshawar. A stratified sample of 155 critical care nurses (ICU, CCU, Emergency) was recruited from a total population of 258 nurses. Data was collected through a validated 12-lead ECG interpretation competency questionnaire (ICC = 0.869 and CVI = 0.87) comprising 12 scenario-based multiple-choice questions. Most nurses had 1–5 years of critical care experience, and 62.6% had not attained formal ECG training. Moderate competence was observed in 62.6% of participants, high competence in 34.2%, and low competence in 3.2%. One-way ANOVA revealed that working experience significantly influenced ECG competence (p < 0.001), while chi-square analysis showed a significant association between ECG training and interpretation score (p = 0.041). No significant difference was observed between nurses in public and private hospitals (p = 0.215). This study provides multi-center evidence of ECG interpretation competency among critical care nurses in Pakistan, informing targeted educational interventions and hospital policies.