January 11, 2016



Currently, there exists very little knowledge about the diversity of Critical Care Nursing education on an international level. Whilst European legislation facilitates the free movement of professionals and the mutual recognition of qualifications, there is no consensus on a competency framework & professional development programme that addresses the increasingly complex tasks carried out by critical care nurses. 

In a survey by Endacott et al (1), the authors investigated current education programmes and examined their existing structures, processes and outcomes. In addition, they tried to identify barriers to advancing Critical Care Nursing education. The methodology was based on the first-phase survey used for CoBaTrICE (2) and 24 (mainly) European countries were represented.

The results show that Critical Care Nursing is not a recognised specialty in many countries. Existing Critical Care Nursing education programs vary in their duration and awarded qualifications. Certification of programmes is mostly undertaken by national or local bodies. In many countries, structured formal documentation is being used to assess nurses’ competency based on knowledge, skills and attitudes, however a dissertation for successful completion mostly not required. One of the main barriers to advancing Critical Care Nursing education noted in the survey was the absence of a national standard within individual countries. In addition, access to educational resources for nurses and a lack of available time for training were also identified. To address these limitations, the authors suggest the development of a European specialist education programme that would lead to a framework in which advanced nursing roles could develop.

This is the first survey that reviewed Critical Care Nursing education on an international level. Out of the 24 countries included, results are presented for 17, reflecting a response rate of 71%. The results were published as a letter and therefore space to present them may have been limited. As such, it would have been interesting to learn about the 7 countries that did not reply, but overall we can estimate that if they were included, the results presented would not have been significantly different. Taking into consideration the link between specialist education and patient outcomes (3) a standardisation of critical care nursing education is overdue. While the medical profession has achieved this through the introduction of the European Diploma for Intensive Care Medicine, the Critical Care Nursing community could benefit from a similar education and competency assessment programme.

In conclusion, this article has highlighted the current state of affairs of Critical Care Nursing and as such has provided a great starting point for the development of an international Critical Care Nursing education strategy.

This article review has been prepared and submitted by Johannes Mellinghoff on behalf of the N&AHP Committee.


(1) Endacott R., Jones C., Bloomer M. J., Boulanger C., Ben Nun M., Lliopoulou K. K., Blot, S. (2015). The state of critical care nursing education in Europe: an international survey. Intensive Care Medicine. (OPEN ACCESS)

(2) Barrett, H., & Bion, J. F. (2005). An international survey of training in adult intensive care medicine. Intensive Care Medicine, 31(4), 553–561.

(3) Aiken, L. H., Clarke, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA. 290(12), 1617–1623. http://doi.org/10.1097/01.sa.0000140535.84061.96


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