{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T05:11:31Z","timestamp":1788757891387,"version":"build-2803163510"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aims to establish a standardized training indicator system for cardiac Intensive Care Unit (CICU) specialized nurses based on competency theory, so as to provide practical guidance for improving their core competencies and guaranteeing high-quality care for critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The training indicator system was developed through literature review, semi-structured qualitative interviews and Delphi method. Literature review was conducted to extract competency dimensions and indicators covering professional knowledge, professional skills, professional competence and practical competence; semi-structured qualitative interviews with clinical and educational specialists were further carried out to develop an initial training indicator system with 4 primary, 19 secondary and 60 tertiary indicators. Followed by two rounds of Delphi consultation, 23 experts specializing in CICU Medicine, CICU nursing management, CICU clinical nursing, and nursing education were invited to participate. Indicators were retained when importance score &amp;gt;3.50 and coefficient of variation &amp;lt;0.25. The Analytic Hierarchy Process (AHP) was used to determine the weights of indicators at different levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both two rounds of expert surveys achieved a 100% response rate, with expert authority coefficients of 0.884 and 0.894, respectively. The Kendall\u2019s ranged from 0.241 to 0.247 (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), and the coefficient of variation ranged from 0.070 to 0.131. The final version of the training indicator system includes 4 first-level indicators, 19 secondary-level indicators, and 63 tertiary-level indicators. All indicators obtained importance scores above 4.47 with reasonable weight distribution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This competency-oriented CICU specialized nurse training indicator system possesses favorable scientificity and operability, and can serve as a reference for standardized professional development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1932888","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:23:01Z","timestamp":1788754981000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Construction of a specialized nurse training Indicator system for cardiac intensive care unit using the Delphi method"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhiyun","family":"Yang","sequence":"first","affiliation":[{"name":"CICU, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Huang","sequence":"additional","affiliation":[{"name":"CICU, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songmei","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiao","family":"Sun","sequence":"additional","affiliation":[{"name":"Cardiacvascular Disease Ward, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyu","family":"Li","sequence":"additional","affiliation":[{"name":"CICU, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Li","sequence":"additional","affiliation":[{"name":"CICU, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongping","family":"Xu","sequence":"additional","affiliation":[{"name":"Cardiacvascular Disease Ward, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Zhang","sequence":"additional","affiliation":[{"name":"CICU, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huili","family":"He","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref1","first-page":"1973","article-title":"A study on the application of standardized nursing procedures in the clinical monitoring and sleep assessment of patients with heart failure in the intensive care unit","volume":"7","author":"Qiang","year":"2020","journal-title":"World J Sleep Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e687","DOI":"10.1161\/CIR.0000000000001300","article-title":"Evolution of critical care cardiology: an update on structure, care delivery, training, and research paradigms: a scientific statement from the American Heart Association","volume":"151","author":"Sinha","year":"2025","journal-title":"Circulation"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1024\/1012-5302\/a001015","article-title":"Primary nursing in the intensive care unit","volume":"38","author":"Kr\u00fcger","year":"2025","journal-title":"Pflege"},{"key":"ref4","first-page":"801","article-title":"National Nursing Development Plan (2021\u20132025)","volume":"22","year":"2022","journal-title":"China Nurs Manag"},{"key":"ref5","first-page":"119","article-title":"Discussion on the establishment of chest pain centers in primary-level hospitals under medical consortiums and the training model for CCU specialized nurses","volume":"7","author":"He","year":"2020","journal-title":"Dietary Health Care"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.16821\/j.cnki.hsjx.2024.21.001","article-title":"Construction of an evaluation index system for the quality of clinical practice teaching services provided by ICU specialized nurses","volume":"39","author":"Guo","year":"2024","journal-title":"J Nurs Cont Educ"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.16821\/j.cnki.hsjx.2021.13.007","article-title":"Four-in-one diversified training practice and its effectiveness in enhancing ICU nurses\u2019 core competencies","volume":"36","author":"Feng","year":"2021","journal-title":"J Nurs Cont Educ"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"244","DOI":"10.16753\/j.cnki.1008-2344.2018.03.016","article-title":"The effect of ICU specialty nurse training on enhancing nurses\u2019 core competencies","volume":"20","author":"Yuan","year":"2018","journal-title":"J Shenyang Med Univ"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3650","DOI":"10.4103\/jfmpc.jfmpc_319_21","article-title":"The impact of critical thinking training using critical thinking cards on clinical decision-making of CCU nurses","volume":"10","author":"Jalalpour","year":"2021","journal-title":"J Family Med Prim Care"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e12402","DOI":"10.1111\/nup.12402","article-title":"Competency frameworks, nursing perspectives, and interdisciplinary collaborations for good patient care: delineating boundaries","volume":"24","author":"Zumstein-Shaha","year":"2023","journal-title":"Nurs Philos"},{"key":"ref11","first-page":"8","article-title":"Investigation and analysis of the current state of nursing competencies and their influencing factors","volume":"14","author":"Liu","year":"2015","journal-title":"Mod Clin Nurs"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.3761\/j.issn.0254-1769.2022.14.011","article-title":"Development of the competency assessment scale for nurses in the central sterile supply department and its reliability and validity testing","volume":"57","author":"Kang","year":"2022","journal-title":"Chin J Nurs"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1186\/s12879-021-06402-2","article-title":"Construction of an index system of core competence assessment for infectious disease specialist nurse in China: a Delphi study","volume":"21","author":"Wu","year":"2021","journal-title":"BMC Infect Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"104728","DOI":"10.1016\/j.nedt.2020.104728","article-title":"Clinical competence in nursing: a hybrid concept analysis","volume":"97","author":"Nabizadeh-Gharghozar","year":"2021","journal-title":"Nurse Educ Today"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"w13062","DOI":"10.4414\/smw.2010.13062","article-title":"Interprofessional collaboration among nurses and physicians: making a difference in patient outcome","volume":"140","author":"Martin","year":"2010","journal-title":"Swiss Med Wkly"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"726647","DOI":"10.3389\/fpubh.2021.726647","article-title":"Design of a clinical practice guideline in nurse-led ventilator-weaning for nursing training","volume":"9","author":"Awang","year":"2021","journal-title":"Front Public Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"E019","DOI":"10.59958\/hsf.8109","article-title":"Impact of nurse practitioners on guideline-directed medical therapy at discharge on patients with recent acute coronary syndrome after coronary artery bypass graft surgery","volume":"28","author":"Ghandour","year":"2025","journal-title":"Heart Surg Forum"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1177\/0269216317690685","article-title":"Guidance on conducting and REporting DElphi studies (CREDES) in palliative care: recommendations based on a methodological systematic review","volume":"31","author":"J\u00fcnger","year":"2017","journal-title":"Palliat Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1960","DOI":"10.1111\/jocn.15462","article-title":"A Delphi study to identify content for a new questionnaire based on the 10 principles of dignity in care","volume":"31","author":"Heuzenroeder","year":"2022","journal-title":"J Clin Nurs"},{"key":"ref20","volume-title":"Research Methods in Nursing","author":"Li","year":"2019"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"104876","DOI":"10.1016\/j.nedt.2021.104876","article-title":"Development of the competency assessment scale for clinical nursing teachers: results of a Delphi study and validation","volume":"101","author":"He","year":"2021","journal-title":"Nurse Educ Today"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2576","DOI":"10.3390\/healthcare10122576","article-title":"Competency in ECG interpretation and arrhythmias management among critical care nurses in Saudi Arabia: a cross sectional study","volume":"10","author":"Aljohani","year":"2022","journal-title":"Healthcare"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"114","DOI":"10.5742\/mewfm.2017.93025","article-title":"The effect of educational training on nurses\u2019 clinical function of cardiopulmonary resuscitation","volume":"15","author":"Jokari","year":"2017","journal-title":"World Fam. Med. J."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3969\/j.issn.1671-8283.2024.10.009","article-title":"Development of a humanistic nursing care plan for conscious ICU patients based on narrative nursing theory","volume":"23","author":"Jin","year":"2024","journal-title":"Modern Clinical Nursing"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1037\/amp0000247","article-title":"Teamwork in the intensive care unit","volume":"73","author":"Ervin","year":"2018","journal-title":"Am Psychol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"4512","DOI":"10.12104\/j.issn.1674-4748.2025.23.022","article-title":"Investigation of the current status of goal-oriented analgesia and sedation management practices among ICU nurses, as well as their knowledge and training needs in this area","volume":"23","author":"Hu","year":"2025","journal-title":"General Nursing"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-025-07037-6","article-title":"Effectiveness of non-technical skills training in intensive care units: a systematic review","volume":"25","author":"Pimenta","year":"2025","journal-title":"BMC Med Educ"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1002\/nop2.1399","article-title":"Paradoxical perception of humanistic care in the intensive care unit: a qualitative study","volume":"10","author":"Hasandoost","year":"2023","journal-title":"Nurs Open"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1932888\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:23:07Z","timestamp":1788754987000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1932888\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":28,"alternative-id":["10.3389\/fmed.2026.1932888"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1932888","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"article-number":"1932888"}}