Identification of priority practice areas for evidence-based care in congenital heart Disease An exploratory Survey of non-medical healthcare professionals affiliated with the Italian Society of Pediatric Cardiology

Abstract Introduction: s Identifying priority areas of nursing practice for individuals with congenital heart disease (CHD) is essential to address evolving care needs and support professional development. However, standardized criteria to guide such prioritization remain limited. Methods: A cross-sectional observational study was conducted between April and September 2024 using an online survey distributed to all nurse members of the Italian Society of Pediatric Cardiology and Congenital Heart Diseases (SICPED). Sixteen CHD-related practice areas and five prioritization criteria were defined through literature review and expert consultation. Participants rated each area on a 5-point Likert scale according to the five criteria. Results: A total of 78 nurses completed the survey. Among the criteria, the absence of clinical guidelines (mean = 4.04 ± 0.98) and the required level of professional competence (mean = 3.95 ± 1.24) received the highest scores. Mixed ANOVA revealed significant variability in scores across practice areas and criteria (F(48) = 2.385, p < .001). Four areas emerged as priority domains across multiple criteria: psychosocial and emotional support for individuals with CHD and their families, management of neonatal opioid withdrawal, palliative and end-of-life care, and the transition of adolescents with CHD to adult services. Conclusions: This study provides a structured foundation for identifying nursing practice priorities in the care of individuals with CHD. These findings may guide the development of interdisciplinary strategies, clinical guidelines, and professional training initiatives within communities of practice. Keywords: Allied health professions; Community of practice; Congenital heart disease; Nursing; Scope of practice.