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Journal of Cardiovascular Nursing


triage, nurses, emergency department, acute coronary syndrome, COVID-19


Background: The COVID-19 pandemic added challenges to patient assessment and triage in the emergency department (ED).

Objective: To describe the effects of the COVID-19 pandemic on ED triage nurse decisions for patients with potential ACS.

Methods: This was a secondary analysis of data from a descriptive, electronic, survey-based study. Participants were asked two questions: whether the COVID-19 pandemic had affected their triage and/or assessment practices for patients with potential ACS and if so, how. Descriptive statistics were used to compare characteristics of participants. A qualitative descriptive approach was used to analyze responses to the open-ended questions about the pandemic’s effect on the triage process.

Results: Participants from across the US had a mean age of 41.7 (12.3) years; 358 (80.6%) were women. The participants had a median of 10.0 (IQR 16.0) years of experience as a registered nurse, with a median 7.0 (IQR 11.0) years of ED experience. A total of 180 of 444 (40.5%) participants indicated that the COVID-19 pandemic affected their triage processes and assessment of potential ACS patients; 156 (86.7%) provided a response to the open-ended question. Responses revealed four themes, 1) Delays in Triage and Treatment; 2) Ambiguous Patient Presentation; 3) Heightened Awareness of COVID-19 Complications and Sequalae; and 4) Process Changes.

Conclusions: Forty percent of ED triage nurses participating reported that triage processes for patients with potential ACS were affected by the COVID-19 pandemic. Most expressed barriers that resulted in delayed assessment and treatment of patients and often resulted from overlapping cardiac symptoms and COVID-19.




This is an accepted manuscript of an article first published in the Journal of Cardiovascular Nursing (2023):10.1097/JCN.0000000000001008.

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