Background: Life-threatening arrhythmias remain a major cause of sudden clinical deterioration and mortality among critically ill patients, particularly in intensive and coronary care units. Early recognition and prompt, protocol-based management are essential for survival. Critical care nurses play a central role in continuous ECG monitoring, early rhythm recognition, initiation of emergency interventions, and coordination of advanced cardiac life support. However, clinical exposure alone does not ensure adequate preparedness, and variability in ECG interpretation and emergency response persists, especially in regional healthcare settings in India where high-quality randomized controlled evidence on structured training interventions is limited.
Objective: To evaluate the effectiveness of a structured arrhythmia training program on improving knowledge and clinical efficiency related to the management of life-threatening arrhythmias among critical care nurses.
Methods: A multicentre, prospective, cluster randomized controlled trial with parallel intervention and control groups was conducted in selected critical care centres of Ranchi district, Jharkhand. A total of 506 critical care nurses participated (253 intervention; 253 control). Hospitals were randomized using cluster randomization. The structured training program included ECG interpretation, identification of life-threatening arrhythmias, protocol-based emergency actions, ECG lead placement, and defibrillator settings. Data were collected using a validated structured knowledge questionnaire (30 items; reliability coefficient 0.97). Statistical analysis included chi-square tests, paired and independent t-tests, and ANOVA with significance set at p < 0.05.
Results: Both groups demonstrated low baseline knowledge (pre-test mean: intervention 8.72 ± 3.93; control 8.84 ± 2.94). Post-intervention, the intervention group showed a significant improvement in knowledge scores (post-test mean 18.11 ± 4.80), while the control group showed no meaningful change (post-test mean 8.85 ± 2.93). The difference between groups was highly statistically significant (p < 0.001). Post-test scores in the intervention group did not differ significantly by experience level, indicating knowledge standardization across professional categories.
Conclusion: Structured arrhythmia training significantly improves knowledge and clinical preparedness of critical care nurses and demonstrates strong potential to enhance clinical efficiency and patient safety in critical care settings.
Keywords: Arrhythmia training; Clinical efficiency; Critical care nurses; ECG interpretation; Structured training program; Multicentric study; Life-threatening arrhythmias
How to cite this article: Kumari S, Singh SK, Singh SB, Kumar A, Impact of structured arrhythmia training on clinical efficiency in critical care units: A Multicentric interventional study. Int J Drug Deliv Technol. 2026;16(4s): 281-286; DOI: 10.25258/ijddt.16.281-286