The Determinants of Cardiac Surgery Nurses’ Competencies; A Systematic Review

Abstract

Cardiac surgery nurses require specialized clinical knowledge, emergency readiness, judgment, communication, and safe postoperative practices. This evidence synthesis examines factors associated with these competencies in forty-four distinct primary reports published between 2016 and 2025. A structured, PRISMA-informed search and narrative approach were used; incomplete database exports and screening logs precluded full PRISMA 2020 verification. The evidence includes qualitative studies, cross-sectional assessments, training evaluations, implementation projects, and selected nurse-guided patient interventions. Recurring domains comprised education, simulation, experience, hemodynamic assessment, emergency response, guideline knowledge, self-efficacy, teamwork, organizational conditions, wound care, pain management, and early mobilization. Education and scenario-based learning were commonly associated with improvements in assessed knowledge or performance, although evidence of durable bedside transfer was uneven. Self-reported confidence, knowledge, observed practice, and patient outcomes were treated as distinct constructs. The review identifies the need for validated specialty competency instruments, sustained training with objective assessment, and stronger examinations of institutional determinants. Its evidence map supports practice-oriented educational planning without claiming an exhaustive systematic screening process or causal ranking of determinants.