Expert Consensus on Key Attributes of Nurses in Resuscitation Teams: Findings From a Delphi Study

BACKGROUND: In-hospital cardiac arrest (IHCA) requires coordinated interdisciplinary action. Nurses are often first responders and essential members of resuscitation teams, yet the attributes that define their effectiveness remain unclear. Although team performance has been widely studied, few works have systematically examined nursing competencies in this context. This is the first Delphi-based study in Greece defining key nursing attributes within in-hospital resuscitation teams. AIM: To achieve expert consensus on the key attributes characterizing effective nursing participation in IHCA teams. STUDY DESIGN: A two-round Delphi study was conducted with experts in resuscitation and critical care. Round one involved thematic analysis of semi-structured interviews. In round two, experts rated attributes on a 10-point Likert scale. Consensus was defined as mean (M) > 8 and coefficient of variation (CV) < 20%. Descriptive statistics and Kendall's W assessed agreement across domains. RESULTS: Thirty-nine attributes were identified and grouped into seven domains: education, experience, physical condition, psychological resilience, technical skills and non-technical skills. Thirty-five attributes met the consensus criteria. Highest agreement was observed for ALS certification, stress resilience, closed-loop communication, adaptability and teamwork. Strongest consensus emerged in non-technical (M = 9.75, CV = 3.79%) and technical (M = 9.61, CV = 5.62%) domains. CONCLUSIONS: This study provides an evidence-informed framework of competencies and personal qualities underpinning nurses' effectiveness in resuscitation teams, emphasizing both technical expertise and non-technical skills-especially closed-loop communication, composure and collaboration. RELEVANCE TO CLINICAL PRACTICE: The framework supports clearer role delineation, structured competency development and enhanced team effectiveness in IHCA management.