Healthcare professionals' knowledge and experience of inherited cardiac arrhythmias (ICA), their views towards and confidence in caring for a person with an ICA in a surgical environment

Abstract

Background
It is estimated that eighteen million major surgeries performed in Europe are non-cardiac surgical procedures. Preventable adverse events remain a challenge within healthcare systems worldwide. Potentially, life-threatening conditions such as inherited cardiac arrhythmias (ICA) can be triggered by a number of factors during the perioperative phase. Healthcare professionals’ lack of knowledge, or clinical confidence about risks associated with inherited cardiac arrhythmias during non-cardiac surgical procedures may have an impact on patient safety and quality of care for people with an inherited cardiac arrhythmia.

Aim
The aim of this study was to determine healthcare professionals’ knowledge and experience of inherited cardiac arrhythmias, their views towards and confidence in caring for a person with an inherited cardiac condition in a surgical environment.

Method
The study has used a multiple method design and Critical Social Theory as a theoretical framework. Stage 1 used a quantitative questionnaire to determine knowledge and level of clinical confidence to care for a person with an inherited cardiac arrhythmia by registered nurses and midwives, surgical and anaesthesiology teams in 17 hospitals in Northern Ireland and the Republic of Ireland. Questionnaire data used descriptive, correlational and inferential statistical analysis. Stage 2 adopted an interpretive qualitative method by semi-structured induvial interviews to gather data on healthcare professionals’ knowledge and experience of inherited cardiac arrhythmias, their views towards and confidence in caring for a person with an inherited cardiac condition in a surgical environment. Data analysis used Braun and Clarke’s (2021) thematic analysis.

Results
One hundred and fifty-four questionnaires were returned in Stage 1 of the study which found there was a lack of knowledge and clinical confidence to care for people with inherited cardiac arrhythmias. It also was found that participants were divided whether knowledge of these conditions were relevant to their professional role. Findings also suggested further education was warranted by healthcare organisations. Interviews took place in two hospitals, one in Northern Ireland and one in the Republic of Ireland (Stage2). Themes identified encompassed gap in knowledge, lack of clinical confidence, reliance on others/relevance to role, reliance on others, the clinical area and what would help and what does not within the surgical hospital environment to help care for people with these conditions. Outputs from the findings include a patient pathway, surgical infographic and conceptual framework for healthful cultures within surgical settings for people with an inherited cardiac arrhythmia.

Conclusions
People with inherited cardiac arrhythmias who present for a non-cardiac surgical procedure are at a greater risk of an adverse event due to lack of knowledge regarding their type of arrhythmia. A fragmented approach to caring for people with inherited cardiac arrhythmias currently exists as healthcare organisations and professionals are unaware this risk factor is a reality. There is a necessity for healthcare professionals to undertake changes to clinical practice, education and further research to ensure that preventable adverse events are prevented.

Thesis embargoed until 30 June 2027

Date of Award	Jun 2025
Original language	English
Supervisor	Neal Cook (Supervisor), Owen Barr (Supervisor) & Pauline Black (Supervisor)