The Role of Nursing Care in the Current Era of Intensive Coronary Care Units

Objectives: During the past 2 decades patients characteristics admitted in the intensive coronary care units (ICCU) have been change due to increase in life expectancy and advances in medical treatment. Nurses in the ICCU need to have more skills than before to treat these challenging patients. The aim of the current study was to describe the role of nursing care in the current era of ICCU.

Methods: A prospective observational registry of patients admitted to the ICCU was conducted between January 2018 and December 2018.

Results: Seven hundred and ninety patients were admitted to the ICCU. Of them 547 (69%) were male with a mean age of 67(±14.5) years old. Major reasons for admission were St-elevation myocardial infarction (STEMI) 22%, non-STEMI 18%, heart failure 10%, post electrophysiology procedures 7%, pulmonary embolism 5%. Moreover, 5% of patients presented with shock on admission, 5% with severe sepsis and 1.5% with out of hospital sudden death. During this first year nurses were required to treat patients with mechanical ventilation in critically ill patients 8%, had to use inotropes in 11% of patients deal with invasive hemodynamics monitoring in 14% of patients. Moreover, mild induced hypothermia using cooling machine was performed in 1% of patients, and emergency defibrillations were performed by either physicians or nurses in 2.7% of patients. This is on top of the routine nursing care of post percutaneous coronary intervention patients in 39% and pacemaker implantation (temporary or permanent) in 11% of patients.

Conclusions: The current population hospitalized in an ICCU is elderly, characterized by a high rate of co-morbidities. Nurses in the ICCU meet variety of challenging patients and complicated situations and has to master numerous skills on top of the ordinary nursing care, in order to deliver adequate and intensive care to this patients.