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Knowledge of Implantable Cardioverter Defibrillator Purpose and Function Among Nurses in the United States

Steffes, Susanne S. RN, DNP; Thompson, Elaine A. RN, PhD; Bridges, Elizabeth M. RN, PhD, FCCM, FAAN; Dougherty, Cynthia M. ARNP, PhD, FAHA, FAAN

Journal of Cardiovascular Nursing: May/June 2017 - Volume 32 - Issue 3 - p 304–310
doi: 10.1097/JCN.0000000000000339
ARTICLES: Implantable Cardioverter Defibrillators

Background: Nurses play a crucial role in patient education and adaptation to having an implantable cardioverter defibrillator (ICD).

Objective: The aim of this study was to assess cardiology nurses’ knowledge and confidence in providing education and support to ICD recipients.

Methods: A cross-sectional descriptive survey was used to assess nurses’ knowledge and experience caring for ICD recipients in 2 academic medical centers in the Pacific Northwest, using an instrument developed in 2004 in the United Kingdom.

Results: Nurses (N = 74) worked on cardiology units or clinics, primarily held a baccalaureate degree or higher (85%), and had 16 years or more of nursing experience and 6 to 10 years of cardiology experience. The overall average knowledge score was 77%, with knowledge about modern ICD technology averaging 55%. Nurses’ confidence, using 10-point scale, in preparing patients to receive an ICD implant was 6.32 ± 2.56, for preparing patients for discharge was 6.14 ± 2.43, and for providing education about ICD shocks was 6.63 ± 2.50. Nurses were most knowledgeable about factors that affect patient retention of knowledge and ICD-related environmental hazards. Nurses lacked knowledge about the basic ICD components, purpose of cardiac resynchronization, and dual-chamber ICDs. Factors associated with higher knowledge scores included past experience caring for a patient with an ICD and working in an electrophysiology outpatient clinic.

Conclusions: The ICD knowledge of US nurses in 2015 was similar to that reported in the United Kingdom in 2004, with limited knowledge about the complexities of modern ICD devices. Such deficits in knowledge may affect the quality of education provided to ICD recipients in preparing them to live safely with an ICD.

Susanne S. Steffes, RN, DNP Advanced Practice Nurse, University of Washington School of Nursing, Seattle.

Elaine A. Thompson, RN, PhD Professor, University of Washington School of Nursing, Seattle.

Elizabeth M. Bridges, RN, PhD, FCCM, FAAN Professor, University of Washington School of Nursing, Seattle.

Cynthia M. Dougherty, ARNP, PhD, FAHA, FAAN Professor, University of Washington School of Nursing, Seattle.

The authors have no funding or conflicts of interest to disclose.

Correspondence Cynthia M. Dougherty, ARNP, PhD, University of Washington School of Nursing, 1959 NE Pacific Street, HSB T615A, Box 357266, Seattle, WA 98195 (

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