Are Emergency Department Triage Nurses Knowledgeable about Acute Coronary Syndromes Recognition?

Abstract

Acute coronary syndrome (ACS) has been the leading cause of death since 1921 and the volume of ED patients with a chest pain chief complaint equates to six million visits annually. Though a common ED patient presentation, triage accuracy rates are low and time delays in patient care are high despite extensive ACS presentation research and published practice guidelines. Objective: Triage nurses must have adequate ACS knowledge to perform prompt recognition and medical response, thereby reducing patient mortality and morbidity. Using the Synergy Model for Patient Care, this study sought to determine if triage nurses within the emergency department have the knowledge to accurately identify patients at risk for ACS. Methods: After pilot testing the instrument, an anonymous electronic survey of 12 closed-ended questions was administered to nurses who met sample criteria at two EDs. Results: Correct answers ranged from 3 (25.00%) to 10 (83.30%) with a mean, median, and mode of 7 (58.30%) and a confidence interval (α) of ±0.04 (6.96, 7.04). The SD for the study is 0.13. No study participants achieved a passing score of 84% or greater accuracy. The independent t-test found significance in the participants years of ED experience with their survey results (P = 0.0056). Simple linear regression determined the slope of this relationship to be 1.191 ± 0.4520. Conclusions: This research facilitates bridging the gap between existing research and practice guidelines through the provision of improved training for ED triage nurses to enhance ACS recognition and medical response which is essential to optimal outcomes for ACS patients.