Triaging women with acute coronary syndrome :A review of the literature

Journal article


Kuhn, Lisa, Page, Karen, Davidson, Patricia M. and Worrall-Carter, Linda. (2011). Triaging women with acute coronary syndrome :A review of the literature. Cardiovascular Nursing, The Journal of. 26(5), pp. 395 - 407. https://doi.org/10.1097/JCN.0b013e31820598f6
AuthorsKuhn, Lisa, Page, Karen, Davidson, Patricia M. and Worrall-Carter, Linda
Abstract

Aims and Objectives: This article analyzes the literature describing factors affecting nurses' triage of emergency department (ED) patients with potential acute coronary syndrome (ACS), with particular attention paid to gender-based differences.

Introduction: Acute coronary syndrome is one of the most time-critical conditions requiring ED nurse triage. This literature review will provide examination of how triage nurses prioritize patients with possible ACS, reflecting on challenges specifically associated with evaluating women for ACS in the ED. The article presents a description of the research findings that may help improve the timely revascularization of ACS in women.

Methods: An electronic search of EBSCOhost CINAHL, Health Source Nursing Academic Edition, MEDLINE, Psychology and Behavioral Sciences Collection databases, online theses, the Cochrane Library, the Joanna Briggs Institute, and National Guideline Clearinghouse resources were used to identify all relevant scientific articles published between 1990 and 2010. Google and Google Scholar search engines were used to undertake a broader search of the World Wide Web to improve completeness of the search. This search technique was augmented by hand searching these articles' reference lists for publications missed during the primary search.

Results: Review of the literature suggests factors such as patient age, sex, and symptoms at ED presentation affect the accuracy of nurses' triage of ACS, particularly for women. However, research examining delays due to ED triage is scant and has predominantly been undertaken by one researcher. Little research has examined triage of ACS specifically in women.

Conclusions: The literature search revealed a small number of articles describing challenges associated with nurse triage of women with ACS. Although most of this published research is North American, the themes uncovered are well supported by broader international research on acute assessment and management of women's ACS. These include the following: gender-based differences in the presentation of ACS can preclude early identification of ACS, advanced patient age often correlates with missed or delayed diagnosis of ACS, and there appears to be a general bias against managing women for ACS in parity with men's disease.

Relevance to Practice: Early reperfusion therapy is critical for optimal health outcomes in ACS. Triage nurses are ideally placed to minimize time to treatment for ACS. An understanding of the issues related to clinical decision making and triage allocation of women with ACS at triage is necessary to ensure appropriate treatment.

Year2011
JournalCardiovascular Nursing, The Journal of
Journal citation26 (5), pp. 395 - 407
ISSN0889-4655
Digital Object Identifier (DOI)https://doi.org/10.1097/JCN.0b013e31820598f6
Scopus EID2-s2.0-80052303108
Page range395 - 407
Research GroupSchool of Nursing, Midwifery and Paramedicine
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Driscoll, Andrea, Worrall-Carter, Linda, Hare, David, Davidson, Patricia, Riegel, Barbara, Tonkin, Andrew and Stewart, Simon. (2009). Evidence-based chronic heart failure management programs: Reality or myth? BMJ Quality and Safety. 18(6), pp. 450 - 455. https://doi.org/10.1136/qshc.2008.028035
Measuring self-care in chronic heart failure: A review of the psychometric properties of clinical instruments
Cameron, Janette, Worrall-Carter, Linda, Driscoll, Andrea and Stewart, Simon. (2009). Measuring self-care in chronic heart failure: A review of the psychometric properties of clinical instruments. The Journal of Cardiovascular Nursing. 24(6), pp. E10 - E22. https://doi.org/10.1097/JCN.0b013e3181b5660f
Opting in and opting out: A grounded theory of nursing's contribution to inpatient rehabilitation
Pryor, Julie, Walker, Annette, O'Connell, Beverley and Worrall-Carter, Linda. (2009). Opting in and opting out: A grounded theory of nursing's contribution to inpatient rehabilitation. Clinical Rehabilitation. 23(12), pp. 1124 - 1135. https://doi.org/10.1177/0269215509343233
Relationship of heart failure patients' knowledge, perceived barriers, and attitudes regarding low-sodium diet recommendations to adherence
Lennie, Terry, Worrall-Carter, Linda, Hammash, M., Odom-Forren, J., Roser, L. P., Smith, C. S., Trupp, T., Chung, Misook and Moser, Debra. (2008). Relationship of heart failure patients' knowledge, perceived barriers, and attitudes regarding low-sodium diet recommendations to adherence. Progress in Cardiovascular Nursing. 23(1), pp. 6 - 11. https://doi.org/10.1111/j.1751-7117.2008.tb00525.x
Improving depression and anxiety screening of patients with heart disease: implementing a multidisciplinary Clinical Pathway
Rahman, Aziz and Worrall-Carter, Linda. (2008). Improving depression and anxiety screening of patients with heart disease: implementing a multidisciplinary Clinical Pathway [Dataset]. Australian Catholic University. https://doi.org/10.26199/acu.89yv4
The impact of an ICU liaison nurse service on patient outcomes
Elliott, Suzanne, Ernest, David, Doric, Andrea, Page, Karen, Worrall-Carter, Linda, Thalib, Lukman and Chaboyer, Wendy. (2008). The impact of an ICU liaison nurse service on patient outcomes. Critical Care and Resuscitation. 10(4), pp. 296 - 300.
ECG interpretation part 1: Understanding mean electrical axis
Kuhn, Lisa and Rose, Louise. (2008). ECG interpretation part 1: Understanding mean electrical axis. Journal of Emergency Nursing. 34(6), pp. 530 - 534. https://doi.org/10.1016/j.jen.2008.01.007
Ethical dilemmas of a large national multi-centre study in Australia: Time for some consistency
Driscoll, Andrea, Currey, Judy, Worrall-Carter, Linda and Stewart, Simon. (2008). Ethical dilemmas of a large national multi-centre study in Australia: Time for some consistency. Journal of Clinical Nursing. 17(16), pp. 2212 - 2220. https://doi.org/10.1111/j.1365-2702.2007.02219.x
Returning to work: Exploring the experiences of women with acute coronary syndromes
Parry, A., Worrall-Carter, Linda, Page, Karen, Kuhn, Lisa, DiGiacomo, Michelle and Davidson, Patricia. (2007). Returning to work: Exploring the experiences of women with acute coronary syndromes. British Journal of Cardiac Nursing. 2(6), pp. 292 - 301.
Depression, anxiety and stress in women following acute coronary syndrome: Implications for secondary prevention
DiGiacomo, Michelle, Davidson, Patricia, Vanderpluym, A., Snell, R. and Worrall-Carter, Linda. (2007). Depression, anxiety and stress in women following acute coronary syndrome: Implications for secondary prevention. Australian Critical Care. 20(2), pp. 69 - 76. https://doi.org/10.1016/j.aucc.2007.03.002
Extent of heart failure self-care as an endpoint to patient education: A review of the literature
Cameron, Jan, Worrall-Carter, Linda, Driscoll, Andrea, New, G. and Stewart, Simon. (2007). Extent of heart failure self-care as an endpoint to patient education: A review of the literature. British Journal of Cardiac Nursing. 2(4), pp. 188 - 197.
Gender differences in adherence to the sodium-restricted diet in patients with heart failure
Chung, Misook, Moser, Debra, Lennie, Terry, Worrall-Carter, Linda, Bentley, B., Trupp, T. and Armentano, D.. (2006). Gender differences in adherence to the sodium-restricted diet in patients with heart failure. Journal of Cardiac Failure. 12(8), pp. 628 - 634. https://doi.org/10.1016/j.cardfail.2006.07.007
Do clinicians know how to use pulse oximetry? A literature review and clinical implications
Elliott, Malcolm, Tate, R. and Page, Karen. (2006). Do clinicians know how to use pulse oximetry? A literature review and clinical implications. Australian Critical Care. 19(4), pp. 139 - 144. https://doi.org/10.1016/S1036-7314(06)80027-5
Assessment of cognitive function in heart failure patients
Wolfe, R, Worrall-Carter, Linda, Foister, K., Keks, N. and Howe, V.. (2006). Assessment of cognitive function in heart failure patients. European Journal of Cardiovascular Nursing. 5(2), pp. 158 - 164. https://doi.org/10.1016/j.ejcnurse.2005.10.005
Heterogeneity of heart failure management programs in Australia
Driscoll, Andrea, Worrall-Carter, Linda, McLennan, Skye, Dawson, Anna, O'Reilly, J. and Stewart, Simon. (2006). Heterogeneity of heart failure management programs in Australia. European Journal of Cardiovascular Nursing. 5(1), pp. 75 - 82. https://doi.org/10.1016/j.ejcnurse.2005.08.001
Rationale and design of the national benchmarking and evidence-based national clinical guidelines for chronic heart failure management programs study
Driscoll, Andrea, Worrall-Carter, Linda and Stewart, Simon. (2006). Rationale and design of the national benchmarking and evidence-based national clinical guidelines for chronic heart failure management programs study. Journal of Cardiovascular Nursing. 21(4), pp. 276 - 282. https://doi.org/10.1097/00005082-200607000-00007
The experiences and adjustments of women following their first acute myocardial infarction
Worrall-Carter, Linda, Jones, T. and Driscoll, Andrea. (2005). The experiences and adjustments of women following their first acute myocardial infarction. Contemporary Nurse. 19(February), pp. 211 - 221.
Psychosocial issues facilitating recovery post-CABG surgery
Theobald, K, Worrall-Carter, Linda and McMurray, Anne. (2005). Psychosocial issues facilitating recovery post-CABG surgery. Australian Critical Care. 18(2), pp. 76 - 85. https://doi.org/10.1016/S1036-7314(05)80006-2
A historical review of the nurse practitioner role in Australia
Driscoll, Andrea, Worrall-Carter, Linda, O'Reilly, J. and Stewart, Simon. (2005). A historical review of the nurse practitioner role in Australia. Clinical Excellence for Nurse Practitioners. 9(3), pp. 141 - 152.
Nurse academics meeting the challenges of scholarship and research
Worrall-Carter, Linda and Snell, R.. (2003). Nurse academics meeting the challenges of scholarship and research. Contemporary Nurse. 16(February), pp. 40 - 50.