2.50
Hdl Handle:
http://hdl.handle.net/10755/162506
Type:
Presentation
Title:
The Effectiveness of the Aid to Cardiac Triage (ACT) Intervention
Abstract:
The Effectiveness of the Aid to Cardiac Triage (ACT) Intervention
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Arslanian-Engoren, Cynthia, RN, PhD, ACNS-BC, FAHA
P.I. Institution Name:University of Michigan School of Nursing
Title:Associate Professor
Contact Address:400 N. Ingalls, Room 2176, Ann Arbor, MI, 48109-5482, USA
Contact Telephone:734-647-0182
Co-Authors:Bonnie Hagerty, RN, PhD, CS; Kim Eagle, MD, FAAC, FAHA
[Annual Conference Research Poster]
Purpose: Studies have reported: 1) disparities in emergency department (ED) nurses' cardiac
decisions based on patient gender; 2) limitations in ED nurses' decisions predictive of diagnosis for acute coronary syndromes, including myocardial infarction (MI) and unstable angina; and 3) ED nurses' reliance on a limited cadre of patient cues to render a triage decision of acute coronary syndromes. These factors may contribute to the cardiac health outcomes of women. The purpose of this exploratory study was to examine the preliminary effectiveness of the Aid to Cardiac Triage (ACT) intervention to improve ED nurses' cardiac triage decisions for women with MI.

Design: A prospective, interventional design was used.

Setting: The study setting was a Midwestern community hospital ED.

Sample: All registered nurses (N = 23) who practice at ED data collection site and who had experience triaging women for complaints suggestive of MI. Excluded from the study were ED nurses who were licensed practical nurses. The majority of the sample was white (87%), female (87%), certified in emergency nursing (13%) and held associate degrees in nursing (57%). The sample was middle age (M = 47.78 years; SD = 8.97) and experienced in ED nursing (M = 15.76 years; SD = 9.96). Human subject approval to conduct this study was obtained from the university affiliated Institutional Review Board and from the data collection site. No names were associated with the data, all data were coded with a number and maintained in a locked cabinet accessible only to the study team.

Methodology: Guided by Donabedian's model of emergency unit patient care, the three phase ACT intervention was conducted: 1) chart reviews were performed to document triage decisions in the ED; 2) a one hour educational session was conducted using clinical vignettes focusing on the clinical presentation of women with MI, gender disparities in ED nurses' cardiac triage decisions and American College of Cardiology/American Heart Association (ACC/AHA) MI practice guidelines, and a triage decision prompt; and 3) chart reviews were performed three months after the ACT program to provide preliminary data about the effectiveness of the intervention. A brief survey of the ED nurses collected data on demographics, experience and education. Patient data recorded from medical charts included demographics, medical history, presenting symptoms, medications, treatment received and ED diagnoses.

Results: A total of 358 charts were reviewed (174 pre and 184 post intervention). The proportion of women receiving an electrocardiogram (ECG) within 10 minutes of ED arrival improved post ACT intervention (8.1% pre vs. 15.2% post; z = -2.07; p = .039). Logistic regression showed nurses were more likely to obtain an ECG for women within 10 minutes of ED arrival (OR = 2.08; p = .044), controlling for presenting symptoms of chest pain, fatigue and back pain, patient age, history of MI/ACS and smoking.

Conclusions: Preliminary evaluation of the ACT intervention indicates that it is effective at improving ED nurses' cardiac triage decisions and adherence to ACC/AHA MI guidelines.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Effectiveness of the Aid to Cardiac Triage (ACT) Interventionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162506-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Effectiveness of the Aid to Cardiac Triage (ACT) Intervention</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Arslanian-Engoren, Cynthia, RN, PhD, ACNS-BC, FAHA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Michigan School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">400 N. Ingalls, Room 2176, Ann Arbor, MI, 48109-5482, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">734-647-0182</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">cmae@umich.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Bonnie Hagerty, RN, PhD, CS; Kim Eagle, MD, FAAC, FAHA</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference Research Poster] <br/>Purpose: Studies have reported: 1) disparities in emergency department (ED) nurses' cardiac <br/>decisions based on patient gender; 2) limitations in ED nurses' decisions predictive of diagnosis for acute coronary syndromes, including myocardial infarction (MI) and unstable angina; and 3) ED nurses' reliance on a limited cadre of patient cues to render a triage decision of acute coronary syndromes. These factors may contribute to the cardiac health outcomes of women. The purpose of this exploratory study was to examine the preliminary effectiveness of the Aid to Cardiac Triage (ACT) intervention to improve ED nurses' cardiac triage decisions for women with MI. <br/><br/>Design: A prospective, interventional design was used.<br/><br/>Setting: The study setting was a Midwestern community hospital ED.<br/><br/>Sample: All registered nurses (N = 23) who practice at ED data collection site and who had experience triaging women for complaints suggestive of MI. Excluded from the study were ED nurses who were licensed practical nurses. The majority of the sample was white (87%), female (87%), certified in emergency nursing (13%) and held associate degrees in nursing (57%). The sample was middle age (M = 47.78 years; SD = 8.97) and experienced in ED nursing (M = 15.76 years; SD = 9.96). Human subject approval to conduct this study was obtained from the university affiliated Institutional Review Board and from the data collection site. No names were associated with the data, all data were coded with a number and maintained in a locked cabinet accessible only to the study team. <br/><br/>Methodology: Guided by Donabedian's model of emergency unit patient care, the three phase ACT intervention was conducted: 1) chart reviews were performed to document triage decisions in the ED; 2) a one hour educational session was conducted using clinical vignettes focusing on the clinical presentation of women with MI, gender disparities in ED nurses' cardiac triage decisions and American College of Cardiology/American Heart Association (ACC/AHA) MI practice guidelines, and a triage decision prompt; and 3) chart reviews were performed three months after the ACT program to provide preliminary data about the effectiveness of the intervention. A brief survey of the ED nurses collected data on demographics, experience and education. Patient data recorded from medical charts included demographics, medical history, presenting symptoms, medications, treatment received and ED diagnoses.<br/><br/>Results: A total of 358 charts were reviewed (174 pre and 184 post intervention). The proportion of women receiving an electrocardiogram (ECG) within 10 minutes of ED arrival improved post ACT intervention (8.1% pre vs. 15.2% post; z = -2.07; p = .039). Logistic regression showed nurses were more likely to obtain an ECG for women within 10 minutes of ED arrival (OR = 2.08; p = .044), controlling for presenting symptoms of chest pain, fatigue and back pain, patient age, history of MI/ACS and smoking.<br/><br/>Conclusions: Preliminary evaluation of the ACT intervention indicates that it is effective at improving ED nurses' cardiac triage decisions and adherence to ACC/AHA MI guidelines.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:21Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:21Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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