Associations Between Perceived Knowledge, Interprofessional Collaboration, Autonomy and the Frequency of Nursing Activities in Paediatric Extracorporeal Membrane Oxygenation: A Cross-Sectional Study.

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) requires coordinated multidisciplinary care. Although registered nurses (RNs) play a critical role, evidence on factors associated with the frequency of ECMO-related nursing activities in paediatric settings remains limited.

AIM: To examine associations between perceived ECMO knowledge, interprofessional collaboration, nursing autonomy and the frequency of ECMO-related nursing activities.

STUDY DESIGN: A multicentre cross-sectional study was conducted. RNs completed questionnaires assessing perceived ECMO knowledge, autonomy, interprofessional collaboration and ECMO-related nursing activities. Data were analysed using bivariate correlations and multivariable linear regression models.

RESULTS: A convenience sample of 83 RNs from four Israeli paediatric intensive care units (median age 36 years (IQR 31-43), 84% female) participated in the study. In bivariate analyses, nursing autonomy was positively correlated with total ECMO nursing activities (Spearman's rs = 0.34, p < 0.01), while interprofessional collaboration was also positively associated (rs = 0.32, p < 0.01). In multivariable analyses, nursing autonomy was associated with greater involvement in administering medication and blood products through the ECMO circuit (B = 0.50, 95% CI [0.21, 0.80], p < 0.001), while perceived ECMO knowledge was associated with greater involvement in device calibration and monitoring (B = 0.39, 95% CI [0.13, 0.64], p = 0.004). RN-perfusionist teamwork was negatively associated with medication and blood administration through the ECMO circuit (B = -0.29, 95% CI [-0.50, -0.08], p = 0.008).

CONCLUSIONS: The frequency of nursing activities in paediatric ECMO care is associated with both individual-level factors (knowledge and autonomy) and interprofessional dynamics. Targeted education and training aimed at enhancing ECMO-related knowledge, nursing autonomy and interprofessional collaboration may support RNs' participation in ECMO-related nursing activities.

RELEVANCE TO CLINICAL PRACTICE: ECMO-specific education, clear role delineation and effective interprofessional collaboration may enhance RNs' participation in paediatric ECMO care.