Enhancing nurses' competence in mechanical ventilation: a quasi-experimental study and its association with patient severity using APACHE II.

BACKGROUND: Mechanical ventilation is a cornerstone of intensive care, requiring ICU nurses to have adequate knowledge, competence, and skills to provide safe, evidence-based care. Although educational programs improve nurses' preparedness, evidence of their impact on patient outcomes remains limited. AIM: To assess ICU nurses' knowledge, professional competence, and clinical practice related to mechanical ventilation following participation in a structured educational program, and to explore the association between nursing competence and patient severity as measured by APACHE II scores. METHODS: A quasi-experimental study design was conducted in the Egyptian Health Care Authority Hospitals in Port Said Governorate. A convenience sample was used. The study involved one group of ICU nurses evaluated pre- and post-educational program, and two separate cohorts of mechanically ventilated patients (50 each) admitted before and after intervention. Nurses and patients were not paired, and patient cohorts differed in case-mix profiles. Four validated assessment tools were utilized to measure nurses' knowledge, competence, clinical skills & patients' demographic and clinical data. RESULTS: ICU nurses demonstrated significantly higher post-training scores in knowledge, professional competence, and clinical performance compared with their pre-training scores (p < 0.001). Moreover, a substantial contrast in APACHE II scores was noted between patient groups before and after the intervention (p < 0.001). Nevertheless, given that APACHE II evaluates the severity of illness upon ICU admission within the initial 24 h and the patient cohorts were distinct, the observed difference is more likely due to diversities in case complexity rather than an impact directly linked to the educational program. CONCLUSION: Participation in the educational program was associated with higher immediate post-training scores in ICU nurses' knowledge, professional competence, and clinical performance. The APACHE II scores of the pre- and post-intervention patient cohorts differed; however, this does not prove that the educational program had a direct impact on patient outcomes. Further multicenter studies with controlled designs are needed to better evaluate the relationship between educational interventions and patient outcomes.