Keywords
Continuous renal replacement therapy
Critical care nursing
Nursing competence
Patient safety
Abstract
Introduction. Acute kidney injury is common in intensive care units and may require Continuous renal replacement therapy (CRRT). Safe delivery of CRRT depends on nurses’ theoretical knowledge and practical competence. This study assessed critical care nurses’ competence in CRRT to identify areas requiring educational support.
Methods. A cross-sectional observational study was conducted among 240 nurses working in intensive care units at three Italian hospitals. Competence was assessed through an online survey using the validated Continuous Renal Replacement Therapy Measurement Competency Tool (CRRT-MCT). Descriptive statistics were used to summarise participant characteristics, training and competence levels.
Results. Most participants (76.7%, n=184) were classified at the novice level, 17.0% (n=41) at the competent level and 4.2% (n=10) at the expert level; 2.1% (n=5) did not reach the novice threshold. Although 71.3% had received CRRT training, 85.4% of trained participants considered it incomplete and unsatisfactory. The greatest knowledge gaps concerned indications for initiating CRRT and the fundamental principles of renal replacement techniques, whereas knowledge of anticoagulation and vascular access was stronger.
Conclusion. The findings indicate substantial educational needs among intensive care nurses involved in CRRT. Structured programmes combining theory, supervised practice and periodic reassessment should be integrated into continuing professional development. The CRRT-MCT can support both organisational competency mapping and individual self-assessment, enabling training to be targeted to identified knowledge gaps and evaluated over time.
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