Effect of patient sex on triage for ischaemic heart disease and treatment onset times: A retrospective analysis of Australian emergency department data

Journal article

Kuhn, Lisa, Page, Karen, Rolley, John and Worrall-Carter, Linda. (2014). Effect of patient sex on triage for ischaemic heart disease and treatment onset times: A retrospective analysis of Australian emergency department data. International Emergency Nursing. 22(2), pp. 88 - 93. https://doi.org/10.1016/j.ienj.2013.08.002
AuthorsKuhn, Lisa, Page, Karen, Rolley, John and Worrall-Carter, Linda
Abstract

Time between emergency department (ED) presentation and treatment onset is an important, but little-researched phase within the revascularization process for ischaemic heart disease (IHD).

Objective:To determine if sex influences triage score allocation and treatment onset for patients with IHD in the ED.

Methods: Retrospective data for patients 18–85 years presenting to EDs from 2005 to 2010 for acute myocardial infarction (AMI), unstable and stable angina, and chest pain were analysed collectively and separately for AMI.

Results: Proportionately more men (61% of males) were triaged correctly for AMI than women (51.4% of females; P < 0.001). Across all triage categories, average treatment time was faster for men than women with AMI (P < 0.001). When incorrectly triaged for AMI, treatment time for men was faster than for women (P = 0.04). When correctly triaged for AMI, there was no difference in mean treatment time between men and women (P = 0.538).

Conclusions: Substantial undertriage of AMI occurred for both sexes, but was worse in women. Incorrect triage led to prolonged treatment times for AMI, with women’s treatment delays longer than men’s. When triaged correctly, both sexes were treated early for AMI, emphasising the need for all patients to be accurately triaged for this time-sensitive disease.

Keywordsemergency department; heart disease; myocardial infarction; time factor; triage; gender
Year2014
JournalInternational Emergency Nursing
Journal citation22 (2), pp. 88 - 93
PublisherElsevier Ltd
ISSN1755-599X
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ienj.2013.08.002
Open accessOpen access
Page range88 - 93
Research GroupNursing Research Institute
Publisher's version
License
Place of publicationUnited Kingdom
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Gholizadeh, Leila, Davidson, Patricia, Salamonson, Yenna and Worrall-Carter, Linda. (2010). Theoretical considerations in reducing risk for cardiovascular diseases : Implications for nursing practice. Journal of Clinical Nursing. 19(15-16), pp. 2137-2145. https://doi.org/10.1111/j.1365-2702.2009.03189.x
Nursing care practices following a percutaneous coronary intervention. Results of a survey of Australian and New Zealand cardiovascular nurses
Rolley, John, Salamonson, Yenna, Dennison, Cheryl and Davidson, Patricia. (2010). Nursing care practices following a percutaneous coronary intervention. Results of a survey of Australian and New Zealand cardiovascular nurses. Journal of Cardiovascular Nursing. 25(1), pp. 75 - 84. https://doi.org/10.1097/JCN.0b013e3181bb419d
Development of clinical practice guidelines for nursing care of people undergoing percutaneous coronary interventions: An Australian and New Zealand collaboration
Rolley, John, Salamonson, Yenna, Dennison, Cheryl and Davidson, Patricia. (2010). Development of clinical practice guidelines for nursing care of people undergoing percutaneous coronary interventions: An Australian and New Zealand collaboration. Australian Critical Care. 23(4), pp. 177 - 187. https://doi.org/10.1016/j.aucc.2010.03.004
Assessment of a self-administered adapted 6-minute walk test
Du, HuiYun, Davidson, Patricia, Everett, Bronwyn, Salamonson, Yenna, Zecchin, Robert, Rolley, John, Newton, Phillip and Macdonald, Peter. (2010). Assessment of a self-administered adapted 6-minute walk test. Journal of Cardiopulmonary Rehabilitation and Prevention. 30(2), pp. 116 - 120. https://doi.org/10.1097/HCR.0b013e3181be7c98
Gender-specific barriers and facilitators to heart failure self-care: A mixed methods study
Riegel, Barbara, Dickson, Victoria, Lisa, Kuhn,, Page, Karen and Worrall-Carter, Linda. (2010). Gender-specific barriers and facilitators to heart failure self-care: A mixed methods study. International Journal of Nursing Studies. 47(7), pp. 888 - 895. https://doi.org/10.1016/j.ijnurstu.2009.12.011
Recovering from an acute cardiac event- the relationship between the depression and life satisfaction.
Page, Karen, Davidson, Patricia, Edward, Karen-Leigh, Allen, Josh, Cummins, Robert, Thompson, David and Worrall-Carter, Linda. (2010). Recovering from an acute cardiac event- the relationship between the depression and life satisfaction. Journal of Clinical Nursing. 19(June), pp. 736 - 743. https://doi.org/10.1111/j.1365-2702.2009.03106.x
Awareness and causal attributions of risk factors for heart disease among immigrant women living in Australia
Gholizadeh, Leila, Salamonson, Yenna, Worrall-Carter, Linda, DiGiacomo, Michelle and Davidson, Patricia M.. (2009). Awareness and causal attributions of risk factors for heart disease among immigrant women living in Australia. Journal of Women's Health. 18(9), pp. 1385 - 1393. https://doi.org/10.1089/jwh.2008.0956
Gender differences in heart failure self-care : A multinational cross-sectional study
Lee, Christopher S., Reigel, Barbara, Driscoll, Andrea, Suwanno, Jom, Moser, Debra K., Lennie, Terry A., Dickson, Victoria V., Cameron, Jan and Worrall-Carter, Linda. (2009). Gender differences in heart failure self-care : A multinational cross-sectional study. International Journal of Nursing Studies. 46(11), pp. 1485-1495. https://doi.org/10.1016/j.ijnurstu.2009.04.004
ECG interpretation Part 2: Determination of bundle branch and fascicular blocks
Rose, Louise and Kuhn, Lisa. (2009). ECG interpretation Part 2: Determination of bundle branch and fascicular blocks. Journal of Emergency Nursing. 35(2), pp. 123 - 126. https://doi.org/10.1016/j.jen.2008.03.009
Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure
Cameron, Janette, Worrall-Carter, Linda, Riegel, Barbara, Lo, Sing Kai and Stewart, Simon. (2009). Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure. Heart & Lung: the journal of acute and critical care. 38(5), pp. 410 - 418. https://doi.org/10.1016/j.hrtlng.2008.11.004
Evidence-based chronic heart failure management programs: Reality or myth?
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
Review of nursing care for patients undergoing percutaneous coronary intervention: a patient journey approach
Rolley, John, Davidson, Patricia, Salamonson, Yenna, Fernandez, Ritin and Dennison, Cheryl. (2009). Review of nursing care for patients undergoing percutaneous coronary intervention: a patient journey approach. Journal of Clinical Nursing. 18(17), pp. 2394 - 2405. https://doi.org/10.1111/j.1365-2702.2008.02768.x
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
Medication adherence self-report instruments. Implications for practice and research
Rolley, John, Davidson, Patricia, Dennison, Cheryl, Ong, Andrew, Everett, Bronwyn and Salamonson, Yenna. (2008). Medication adherence self-report instruments. Implications for practice and research. Journal of Cardiovascular Nursing. 23(6), pp. 497 - 505. https://doi.org/10.1097/01.JCN.0000338931.96834.16
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
Relating new graduate nurse competence to frequency of use
Hengstberger-Sims, Cecily, Cowin, Leanne, Eagar, Sandy, Gregory, Linda, Andrew, Sharon and Rolley, John. (2008). Relating new graduate nurse competence to frequency of use. Collegian. 15(2), pp. 69 - 76. https://doi.org/10.1016/j.colegn.2008.02.003
Competancy measurements: testing convergent validity for two measures
Cowin, Leanne, Hengstberger-Sims, Cecily, Eagar, Sandy, Gregory, Linda, Andrew, Sharon and Rolley, John. (2008). Competancy measurements: testing convergent validity for two measures. Journal of Advanced Nursing. 64(3), pp. 272 - 277. https://doi.org/10.1111/j.1365-2648.2008.04774.x
Psychometric properties of the Australian nurse competency 2000 standards
Andrew, Sharon, Gregory, Linda, Cowin, Leanne, Eagar, Sandy, Hengstberger-Sims, Cecily and Rolley, John. (2008). Psychometric properties of the Australian nurse competency 2000 standards. International Journal of Nursing Studies. 45(10), pp. 1512 - 1515. https://doi.org/10.1016/j.ijnurstu.2007.10.008
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
Diabetes and heart disease
Rolley, John, Salamonson, Yenna and Davidson, Patricia. (2008). Diabetes and heart disease. Australian Nursing and Midwifery Journal. 16(1), pp. 33 - 34.
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.