6th Edition of World Nursing Science Conference 2026

Abstract

Introduction: Nearly all patients admitted to Critical Care Units (CCU) require close monitoring due to the serious cardiovascular conditions they have as acute coronary syndrome (acute myocardial infarction and angina). Those patients are at higher risk for developing cardiac arrhythmias leading to serious complications. These complications might prolong the hospital's length of stay and result in the exhaustion of healthcare system resources. Therefore, it is important to discover these cardiac arrhythmias as early as possible to prevent the occurrence of these complications. In addition, faster evaluation of cardiac arrhythmias results in earlier treatment planning and higher patient survival rates. Nurses are the front-line healthcare providers dealing with the patients in the CCU. Consequently, they should be at the highest level of competency to detect any abnormal cardiac rhythm, especially life-threatening ones. Despite that, different research has shown that for many nurses, ECG interpretation may be challenging. Therefore, there is an urgent need to improve nurses' ECG interpretation abilities since their lack of ECG identification competency could increase patient morbidity and death. The purpose of this study was to check the hypothesis that CCU nurses who received SMS messages would be better at interpreting cardiac arrhythmias than the control group.

Methodology: This was a randomized control trial with a pre-test and post-test. 70 CCU nurses were randomized into an intervention and control group; 35 each. The intervention consisted of WhatsApp SMS of rhythms that nurses found difficult to interpret based on the literature on atrial fibrillation; namely, atrial flutter, ventricular tachycardia, torsades de pointes rhythm, ventricular fibrillation, asystole, heart block, in addition to normal sinus rhythm. The WhatsApp SMS included the details of each arrhythmia, as well as the rhythm strip illustrative of pictures of cardiac irregularities. The WhatsApp SMS was sent to the intervention groups two times a week (on Monday and Thursday) for 10 weeks by the principal investigator. To evaluate CCU nurses' competency in interpreting cardiac arrhythmias, a specific test was developed by specialized professors in critical care and validated by 7 experts for the content validity index.

Results: A total of 70 CCU nurses participated in this RCT, 46 females, and 24 males, with a mean age of 26.3±2.6 years. The majority of sample 63 (90%) was holding a Bachelor's degree. The results of the independent t-test showed that at baseline there was no statistically significant difference between the intervention and the control group (M[SD]; 12.28±2.64 vs. 11.72±2.8, t=0.99, p=0.46). However, after the intervention, the intervention group has a higher mean score compared to the control group (M[SD]; 16.60±2.23 vs. 11.40±3.10, t=10.40, p <0.001). Paired t-test showed that the intervention group had higher mean levels at the reassessment compared to the baseline, however, there were no differences in regards to the control group; (M[SD]; 16.60±2.23 vs. 12.28±2.64, t=8.64, p <0.001), (M[SD]; 11.72±2.8 vs. 11.40±3.10, t=0.30, p=0.21) respectively.

Conclusion: The outcomes showed that at 10 weeks, nurses in the intervention group had scores that were considerably higher than those in the control group. Based on that, it is possible to incorporate sending SMS messages using WhatsApp into CCU nurses' clinical education.