1) This study assessed the critical care skills of nurses working in the intensive care unit (ICU) and coronary care unit (CCU) of B. P. Koirala Institute of Health Sciences, Dharan, Nepal. It evaluated their skills in 71 different critical care areas. 2) A descriptive cross-sectional study was conducted using a questionnaire to collect data from the 35 nurses working in the ICU and CCU over a period of one week. 3) The results found that nurses were most confident in their skills of starting peripheral IVs, isolation techniques, ventilator care and drug infusion pumps. They had more limited skills in interpreting arrhythmias, temporary pacing and hemodialysis

1. Critical Care Nurses’ Skill
Working in B P Koirala Institute
of Health Sciences Nepal
Ram Sharan Mehta, Ph.D.
B. P. Koirala Institute of Health Sciences
Email: ramsharanmehta7@yahoo.com

2. Introduction: Critical care nurses work in a wide variety of settings and
filling many roles. Rapid advances in healthcare and technology have
contributed to keeping more people out of the hospital.
Objectives: The objective of this study was to assess the skills to care the
critically ill patients among the nurses working in critical care unit
(ICU and CCU) of B. P. Koirala Institute of Health Sciences
(BPKIHS), Dharan, Nepal.
Main Areas of Skills:
1. General Critical Care Nursing Skills: 4-Components
2. Cardiovascular Procedures related skills: 12-Components
3. Pulmonary Procedures: 15-Components
4. Neurological Procedures: 8-Components
5. GI, Renal and Endocrine Procedures: 6-Components
6. Medication skills: 15- Components
7. Pain/Wound management: 8-Components
8. Experiences with age groups: 3-Components
Total: 71 critical care skills

3. Methodology:
• It was hospital based descriptive cross sectional study
conducted among the staff-nurses involved in the care of
patients working in ICU and CCU of BPKIHS for more than
three months.
• Using total enumerative sampling technique all the 35
nurses working in ICU and CCU of BPKIHS was selected for
study.
• Informed verbal consent was obtained prior to data
collection.
• Subjects were assured about the confidentiality of the
Information they were provided and used for the study
purpose only.
• Using pre-tested questionnaire the data was collected
during the period of 1-7-2010 to 7-7-2010 for a week and
special consideration was maintained to avoid the
contamination of sample.

4. Skill /Experiences of Nurses Regarding Critical Care Activities (N= 35)
SN
Critical Care Nursing Skills
(Common Skills)
Responses in Percentage
(%)
Theory,
NoPractice
(0)
Limited
(1)
Confident
(2)
Very
confident
(3)
1 Transport ICU patient within hospital for testing 17.1 8.6 57.1 17.1
2 Start peripheral IV 0 14.3 54.3 31.4
3 Maintain Isolation technique 8.6 11.4 57.1 22.9
4 Draw blood samples from central line 17.1 8.6 34.3 40
5 Remove central line 20 8.6 40 31.4
6
Provide care for the patient requiring temporary
pacing
42.9 40 11.4 5.7
7 Assess lung sounds 11.4 45.7 34.3 8.6
8 Interpret ABG 11.4 20 42.9 25.7

5. Skill (continue)………………………… (N= 35)
SN
Critical Care Nursing Skills
(Common Skills)
Responses in Percentage
(%)
Theory,
NoPractice
(0)
Limited
(1)
Confident
(2)
Very
confident
(3)
9 Assist with chest tube insertion 20 25.7 42.9 11.4
10
Provide care for the patient with mechanical
ventilation 2.9 11.4 60 25.7
11 Provide care for the patient in a comatose state 20 28.6 45.7 5.7
12 Provide care for the patient with hemodialysis 22.9 37.1 25.7 14.3
13 Provide care for the patient with DKA 14.3 37.1 37.1 11.4
14 Provide care for the patient with TPN 28.6 17.1 40 14.3
15 Use IV infusion pump to calculate drug doses 5.7 11.4 54.3 28.6
16 Provide age-appropriate education 14.3 40 37.1 8.6

6. Conclusions:
Most of the nurses were younger (<25) years and
had lesser critical care experiences (<3Yrs) and
very limited had received BLS and ALS training.
The areas where nurses had more skill were
starting peripheral IV, giving discharge teaching,
assessing heart sound and peripheral pulses, care
of arterial line, where as nurses had limited skill
scores on interpret arrhythmias, temporary
pacing, intervene for arrhythmias and
hemodialysis. The skill development training for
nurses working in critical care is mandatory for
quality care. Skill development training for nurses
working in the unit is urgent need for quality
nursing service in critical care unit.
Thank you