Identifying the Acute Coronary Syndrome Patient: Triage Nurses: Perceptions and Practice

2.50
Hdl Handle:
http://hdl.handle.net/10755/162950
Type:
Presentation
Title:
Identifying the Acute Coronary Syndrome Patient: Triage Nurses: Perceptions and Practice
Abstract:
Identifying the Acute Coronary Syndrome Patient: Triage Nurses: Perceptions and Practice
Conference Sponsor:Emergency Nurses Association
Conference Year:2002
Author:Smith, Deborah, RN, BSN, CNIV
P.I. Institution Name:Duke University
Contact Address:107 Mosswood Court, Chapel Hill, NC, 27516, USA
Co-Authors:Mary Nahm, RN, MSN
Purpose: One-third of Acute Coronary Syndrome (ACS) patients present to the ED without typical ischemic chest pain. Yet many, if rapidly identified, would receive the greatest benefits of early aggressive treatment. Targeted triage nursing assessment is critical to determine patients at risk for ACS and to "drive rapid treatment." The purpose of this study was to examine the triage nurse's knowledge regarding cardiac assessment and risk stratification practices. Design/setting: In a descriptive study, 73 triage nurses in four North Carolina hospitals (university, urban and rural) were interviewed to elicit how nurses determine which characteristics, risk factors and symptoms are useful in identifying patients experiencing ACS. Sample: A convenience sample of nurses with ADN or BSN degrees, who consented to an interview, was used. Participants had an average of 7 years of ED triage experience, 13 years of nursing experience. Methodology: All questions, based on results of current risk stratification research and literature, were reviewed for content validity by a panel of emergency physician and nursing experts. One-to-one structured interviews were conducted using the questionnaire. Results: The majority of the nurses interviewed could not define ACS. They considered symptoms of diaphoresis, shortness of breath, poor skin color, as well as patient statements and behaviors to be more significant identifiers of ACS than known cardiac medical history or risks. However, positive cardiac history triggered a sense of urgency for treatment. Forty percent of nursing triage questions focused on pain characteristics. Nurses identified differences in presentation in younger verses older patients, diabetics, and women. Forty-three percent of the responses indicated that nurses did not differentiate questions based on patient sex. Nurses did not ask specific questions to focus on "atypical" presenters. Conclusions: Nurses identify classic symptoms of ischemia and common cardiac factors; however, they may have a lower index of suspicion for patients with atypical symptom presentation, despite current literature reports. Development of a targeted nursing assessment tool may be helpful to ensure nurses ask the best questions, consider significant risk factors and capture "atypical" presenters in triage practice. [Research Paper Presentation]
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.titleIdentifying the Acute Coronary Syndrome Patient: Triage Nurses: Perceptions and Practiceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162950-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Identifying the Acute Coronary Syndrome Patient: Triage Nurses: Perceptions and Practice</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">2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Smith, Deborah, RN, BSN, CNIV</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Duke University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">107 Mosswood Court, Chapel Hill, NC, 27516, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">smith072@mc.duke.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mary Nahm, RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: One-third of Acute Coronary Syndrome (ACS) patients present to the ED without typical ischemic chest pain. Yet many, if rapidly identified, would receive the greatest benefits of early aggressive treatment. Targeted triage nursing assessment is critical to determine patients at risk for ACS and to &quot;drive rapid treatment.&quot; The purpose of this study was to examine the triage nurse's knowledge regarding cardiac assessment and risk stratification practices. Design/setting: In a descriptive study, 73 triage nurses in four North Carolina hospitals (university, urban and rural) were interviewed to elicit how nurses determine which characteristics, risk factors and symptoms are useful in identifying patients experiencing ACS. Sample: A convenience sample of nurses with ADN or BSN degrees, who consented to an interview, was used. Participants had an average of 7 years of ED triage experience, 13 years of nursing experience. Methodology: All questions, based on results of current risk stratification research and literature, were reviewed for content validity by a panel of emergency physician and nursing experts. One-to-one structured interviews were conducted using the questionnaire. Results: The majority of the nurses interviewed could not define ACS. They considered symptoms of diaphoresis, shortness of breath, poor skin color, as well as patient statements and behaviors to be more significant identifiers of ACS than known cardiac medical history or risks. However, positive cardiac history triggered a sense of urgency for treatment. Forty percent of nursing triage questions focused on pain characteristics. Nurses identified differences in presentation in younger verses older patients, diabetics, and women. Forty-three percent of the responses indicated that nurses did not differentiate questions based on patient sex. Nurses did not ask specific questions to focus on &quot;atypical&quot; presenters. Conclusions: Nurses identify classic symptoms of ischemia and common cardiac factors; however, they may have a lower index of suspicion for patients with atypical symptom presentation, despite current literature reports. Development of a targeted nursing assessment tool may be helpful to ensure nurses ask the best questions, consider significant risk factors and capture &quot;atypical&quot; presenters in triage practice. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:56Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:56Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.