Document Type
Article
Publication Date
1-2024
Publication Title
Journal of Emergency Nursing
Keywords
Triage, Emergency department, Acute coronary syndrome, Chest pain, Angina
Abstract
Introduction: Prompt recognition of acute coronary syndrome (ACS) is critical to facilitate timely treatments to preserve the myocardium. Aims of the study were to: 1) identify the symptoms used to assess angina; 2) determine how emergency nurses make triage decisions for potential ACS; and 3) determine emergency nurses’ initial actions.
Methods: This was a cross-sectional, survey-based design. Emergency nurses were recruited through a posting on the Emergency Nurses Association (ENA) website and through postcards. Measures included demographic data, assessment of angina, and the Nurses Cardiac Triage Instrument. Data were analyzed using descriptive statistics and ordinal logistic regression.
Results: A total of 414 registered nurses (RN) with a mean age of 41.7 (±12.0) years participated. They were predominantly female (80.7%), had a baccalaureate degree (60.1%), and worked as a RN for a median 10.0 years. Common terms used to assess angina were chest pain (79.5%), chest pressure (77.3%), chest tightness (72.9%), and chest discomfort (72.5%). The severity of chest pressure (MDN 5.0, IQR 1.0) and nature of chest pain (MDN 5.0, IQR 1.0) had the highest overall median scores to support initial cardiac triage decisions. Associated symptoms of diaphoresis, fatigue, and shortness of breath along with health history contributed to decision-making. Initial RN actions were to obtain an electrocardiogram (ECG), prepare patient for the cardiac catheterization laboratory, and notify the emergency department (ED) physician.
Conclusion: Emergency nurses primarily used chest symptoms and health history when deciding to evaluate for ACS in the ED. Associated symptoms of diaphoresis, fatigue, and shortness of breath, along with health history, also contributed to decision-making. Initial RN actions were to obtain an ECG, prepare the patient for the cardiac catheterization laboratory, and notify the ED physician of the patient’s admission.
DOI
10.1016/j.jen.2023.08.011
Recommended Citation
Blakeman, John R.; Kim, MyoungJin; Eckhardt, Ann L.; Stapleton, Stephen J.; and DeVon, Holli A., "A Nationwide Study of Emergency Nurses’ Triage Decisions for Potential Acute Coronary Syndrome" (2024). Faculty Publications - Mennonite College of Nursing. 33.
https://ir.library.illinoisstate.edu/fpnrs/33
Comments
This is the accepted manuscript of an article first published in Journal of Emergency Nursing 50, no 1 (January 2024): 72-83. Please consult the publisher's version at https://doi.org/10.1016/j.jen.2023.08.011.