Early Recognition and Management Skills of Emergency Department Nurses in Handling Acute Coronary Syndrome

Authors

  • Vergel A. Mancenido Sacred Heart College of Lucena City, Inc. Author

DOI:

https://doi.org/10.5281/zenodo.21862346

Keywords:

acute coronary syndrome, early recognition, management skills

Abstract

One of the most prevalent reasons for cardiac-related hospital admission is Acute Coronary Syndrome (ACS). Given the prevalence of ACS, nurses must be familiar with diagnostic techniques and pharmacological and coronary treatments. Hence, this paper determined the level of knowledge on early recognition and management skills of 110 Emergency Department (ED) nurses in handling patients with ACS in a tertiary level hospital in Riyadh, KSA. A descriptive-quantitative type of research design was used and found that the majority of the respondents were 23 – 39 years old (86%), female (84%), and had bachelor's degrees (80%). Eighty-five (85%) of them had adequate knowledge of early recognition of ACS. Position (p=0.01) and years of experience (p=0.00) as ED nurses were associated with the overall knowledge, whereas training attended (p=0.01), position (p=0.01), and years of experience (p=0.00) were associated with the ED nurse's management skills in handling ACS. The study produced an Integrated Training Program on Triaging ACS for New Nurses, which aims to improve the competency of newly hired nurses, those with less than one year of experience as an ED nurse, and those working as Staff Nurse III in the early detection and management of ACS in the ED.

Downloads

Download data is not yet available.

References

Abu-Assi, E., García-Acuña, J. M., Peña-Gil, C., & González-Juanatey, J. R. (2010). Validation of the GRACE Risk Score for predicting death within 6 months of follow-up in a contemporary cohort of patients with acute coronary syndrome. Revista Española de Cardiología, 63(6), 640–648.

ACS Clinical Advisory Group. (2020). Clinical guidelines for acute coronary syndrome (ACS) 2020. Council of Health Insurance. https://www.cchi.gov.sa/AboutCCHI/CCHIprograms/Documents/Acute%20Coronary%20Syndrome.pdf

Al-Busaidi, I. S., Al Suleimani, S. Z., Dupo, J. U., Al Sulaimi, N. K., & Nair, V. G. (2019). Nurses’ knowledge, attitudes, and implementation of evidence-based practice in Oman: A multi-institutional, cross-sectional study. Oman Medical Journal, 34(6), 521–527. https://doi.org/10.5001/omj.2019.96

Al-Ftlawy, D. (2022). Determination of nurses’ knowledge toward care provided to patients with acute myocardial infarction in Al-Najaf City. Kufa Journal for Nursing Sciences, 2(2), 115–128. https://journal.uokufa.edu.iq/index.php/kjns/article/view/3132

AlFaleh, H. F., Al Shamiri, M. Q., Ullah, A., AlHabib, K. F., Hersi, A. S., AlSaif, S., AlNemer, K., Taraben, A., Malik, A., Abuosa, A. M., LA, M., & Kashour, T. (2015). Disparities in health care delivery and hospital outcomes between non-Saudis and Saudi nationals presenting with acute coronary syndromes in Saudi Arabia. PLOS ONE, 10(4), Article e0124012. https://doi.org/10.1371/journal.pone.0124012

Alhabib, K. F., Hersi, A., AlFaleh, H., Alnemer, K., Alsaif, S., Taraben, A., Kashour, T., Bakheet, A., Qarni, A. A., Soomro, T., Malik, A., Ahmed, W. H., Abuosa, A. M., Butt, M. A., Almurayeh, M. A., Zaidi, A. A., Hussein, G. A., Balghith, M. A., & Abu-Ghazala, T. (2011). Baseline characteristics, management practices, and in-hospital outcomes of patients with acute coronary syndromes: Results of the Saudi Project for Assessment of Coronary Events (SPACE) registry. Journal of the Saudi Heart Association, 23(4), 233–239. https://doi.org/10.1016/j.jsha.2011.05.004

AlHabib, K. F., Hersi, A., AlFaleh, H., Kurdi, M., Arafah, M., Youssef, M., AlNemer, K., Bakheet, A., AlQarni, A., Soomro, T., Taraben, A., Malik, A., & Ahmed, W. H. (2009). The Saudi Project for Assessment of Coronary Events (SPACE) registry: Design and results of a phase I pilot study. Canadian Journal of Cardiology, 25(7), e255–e258. https://doi.org/10.1016/s0828-282x(09)70513-6

Alhassan, S. M., Alharbi, M. S., Algorinees, R. M. S., Alghuraymi, A. A., & Alsaif, M. A. B. (2016). Incidence of acute coronary syndrome (ACS) in Northern Saudi Arabia. European Academic Research, 3(12), 12982–12993.

Alhabib, K. F., Kinsara, A. J., Alghamdi, S., Al-Murayeh, M., Hussein, G. A., AlSaif, S., Khalaf, H., Alfaleh, H., Hersi, A., Kashour, T., Al-Saleh, A., Ali, M., Ullah, A., Mhish, H., Abdo, A. N., Almutairi, F., Arafah, M. R., AlKutshan, R., Aldosari, M., … AlHarbi, I. A. (2019). The first survey of the Saudi Acute Myocardial Infarction Registry Program: Main results and long-term outcomes (STARS-1 Program). PLOS ONE, 14(5), Article e0216551. https://doi.org/10.1371/journal.pone.0216551

Alluhidan, M., Tashkandi, N., Alblowi, F., Omer, T., Alghaith, T., Alghodaier, H., Alazemi, N., Tulenko, K., Herbst, C. H., Hamza, M. M., & Alghamdi, M. G. (2020). Challenges and policy opportunities in nursing in Saudi Arabia. Human Resources for Health, 18(1), Article 98. https://doi.org/10.1186/s12960-020-00535-2

Alquraini, M., Awad, E., & Hijazi, R. (2015). Reliability of Canadian Emergency Department Triage and Acuity Scale (CTAS) in Saudi Arabia. International Journal of Emergency Medicine, 8(1), Article 80. https://doi.org/10.1186/s12245-015-0080-5

Alsadaan, N., Jones, L. K., Kimpton, A., & DaCosta, C. (2021). Challenges facing the nursing profession in Saudi Arabia: An integrative review. Nursing Reports, 11(2), 395–403. https://doi.org/10.3390/nursrep11020038

Alzahrani, F., & Kyratsis, Y. (2017). Emergency nurse disaster preparedness during mass gatherings: A cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia. BMJ Open, 7(4), Article e013563. https://doi.org/10.1136/bmjopen-2016-013563

Ammouri, A. A., Raddaha, A. A., Dsouza, P., Geethakrishnan, R., Noronha, J. A., Obeidat, A. A., & Shakman, L. (2014). Evidence-based practice: Knowledge, attitudes, practice and perceived barriers among nurses in Oman. Sultan Qaboos University Medical Journal, 14(4), e537–e545.

Amsterdam, E. A., Wenger, N. K., Brindis, R. G., Casey, D. E., Ganiats, T. G., Holmes, D. R., ... & Zieman, S. J. (2014). 2014 AHA/ACC guideline for the management of patients with non–ST-elevation acute coronary syndromes: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 64(24), e139–e228. https://doi.org/10.1016/j.jacc.2014.09.017

Arafat, A., Al-Farhan, A., & Abu Khalil, H. (2016). Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in an urgent care center in Saudi Arabia. International Journal of Emergency Medicine, 9(1), Article 17. https://doi.org/10.1186/s12245-016-0112-9

Argaw, Z., Tamiru, S., Ayalew, Y., & Habte, T. (2019). Knowledge and attitude towards care of elder patients and associated factors among nurses working in government hospitals in Addis Ababa, Ethiopia. International Journal of Scientific & Engineering Research, 9(12), 1–14.

Bonzi, M., Fiorelli, E. M., Angaroni, L., Furlan, L., Solbiati, M., Colombo, C., ... & Costantino, G. (2014). Predictive accuracy of triage nurses evaluation in risk stratification of syncope in the emergency department. Emergency Medicine Journal, 31(11), 877–881. https://doi.org/10.1136/emermed-2013-202868

Bullard, M., Melady, D., Emond, M., Musgrave, E., Unger, B., Van der Linde, E., & Swain, J. (2017). Guidance when applying the Canadian Triage and Acuity Scale (CTAS) to the geriatric patient: Executive summary. Canadian Journal of Emergency Medicine, 19(S2), S28–S37. https://doi.org/10.1017/cem.2017.363

Canadian Triage and Acuity Scale. (2013). CTAS combined adult and pediatric programs participant manual (v2.5b). http://ctasphctas.ca/wpcontent/uploads/2018/05/participant_manual_v2.5b_november_2013_0.pdf

Cetin, S. B., Eray, O., Cebeci, F., Coskun, M., & Gozkaya, M. (2020). Factors affecting the accuracy of nurse triage in tertiary care emergency departments. Turkish Journal of Emergency Medicine, 20(4), 163–167. https://doi.org/10.4103/2452-2473.297462

Chaghari, M., Saffari, M., Ebadi, A., & Ameryoun, A. (2017). Empowering education: A new model for in-service training of nursing staff. Journal of Advances in Medical Education & Professionalism, 5(1), 26–32.

Chan, H. Y., Kwok, A. O., Yuen, K. K., Au, D. K., & Yuen, J. K. (2020). Association between training experience and readiness for advance care planning among healthcare professionals: A cross-sectional study. BMC Medical Education, 20(1), Article 451. https://doi.org/10.1186/s12909-020-02347-3

Chan Pin Yin, D., Azzahhafi, J., & James, S. (2020). Risk assessment using risk scores in patients with acute coronary syndrome. Journal of Clinical Medicine, 9(9), Article 3039. https://doi.org/10.3390/jcm9093039

Chin, M., Cummings, T., Thomas, C., & Seemungal, T. (2015). Global Registry of Acute Coronary Events (GRACE) risk score as a predictor of in-hospital mortality for acute coronary syndrome in Trinidad and Tobago. The West Indian Medical Journal, 65(1), 52–59. https://doi.org/10.7727/wimj.2014.172

Darsin Singh, S. K., Ahmad, A., Rahmat, N., & Hmwe, N. T. T. (2018). Nurse-led intervention on knowledge, attitude, and beliefs towards acute coronary syndrome. Nursing in Critical Care, 23(4), 186–191. https://doi.org/10.1111/nicc.12240

Davis, A., & Maisano, P. (2016, September). Patricia Benner: Novice to expert – A concept whose time has come (again). The Oklahoma Nurse, 13.

Davis, L. L., & Maness, J. J. (2019). Nurse practitioner knowledge of symptoms of acute coronary syndrome. The Journal for Nurse Practitioners, 15(1), e9–e12. https://doi.org/10.1016/j.nurpra.2018.09.017

Dehmer, G. J., Badhwar, V., Bermudez, E. A., Cleveland, J. C., Jr., Cohen, M. G., D'Agostino, R. S., Ferguson, T. B., Jr., Fontana, G. P., Hendel, R. C., Jacobs, A. K., Patel, M. R., Shaw, L. J., Thomas, K. T., & American College of Cardiology/American Heart Association Task Force on Clinical Data Standards. (2020). 2020 AHA/ACC key data elements and definitions for coronary revascularization: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Coronary Revascularization). Circulation: Cardiovascular Quality and Outcomes, 13(7), Article e000059. https://doi.org/10.1161/HCQ.0000000000000059

Dorri, S., Farahani, M. A., Mohammadebrahimi, H., Shahraki, S., & Hakimi, H. (2021). Reduction of the rate of hospitalization in patients with acute coronary syndrome: An action research. Iranian Journal of Nursing & Midwifery Research, 26(3), 258–265. https://doi.org/10.4103/ijnmr.IJNMR_219_19

D'souza, E. (2019). An overview and awareness of acute coronary syndrome based on risk factors, early clinical assessment tools, and improving clinical outcomes. Journal of Doctoral Nursing Practice, 12(1), 125–131. https://doi.org/10.1891/2380-9418.12.1.125

Eisa, W. A., & Alenizi, A. A. (2020). Assessment of knowledge and performance regarding triage among nurses working in emergency unit-Al Dawadmi General Hospital: A cross-sectional study. Indian Journal of Forensic Medicine & Toxicology, 14(4), 8613–8618.

Eisen, A., Giugliano, R. P., & Braunwald, E. (2016). Updates on acute coronary syndrome: A review. JAMA Cardiology, 1(6), 718–730. https://doi.org/10.1001/jamacardio.2016.2049

Elkareem Mohammed, W. S., & Salih, S. A. M. (2016). Assessment of nurse’s knowledge and practice regarding care of patients with acute coronary syndrome in Elmak Nimer University Hospital [Unpublished dissertation]. Shendi University.

Ettinger, S. M., Fang, J. C., Fesmire, F. M., Franklin, B. A., Granger, C. B., Krumholz, H. M., Linderbaum, J. A., Morrow, D. A., Newby, L. K., Ornato, J. P., Ou, N., Radford, M. J., Tamis-Holland, J. E., Tommaso, C. L., & American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. (2013). 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 127(4), e362–e425. https://doi.org/10.1161/CIR.0b013e3182742cf6

Faisal, A., Bander, A., Ali, A., Abadi, M., Ahmed, A., & Alsubaie, A. (2019). Acute coronary syndrome among young patients in Saudi Arabia (single center study). Journal of Cardiology & Current Research, 12(3), 60–63. https://doi.org/10.15406/jccr.2019.12.00440

Fares, S. A., Maghraby, M. H. E. D., El-shafiey, O. A. A. G., & Mehany, M. M. (2019). Effect of an educational program on nurses’ knowledge & practices regarding assessment of acute coronary syndrome. Assiut Scientific Nursing Journal, 7(19), 108–116. https://doi.org/10.21608/asnj.2019.57682

Franco, J. V. A., Arancibia, M., Meza, N., Madrid, E., & Kopitowski, K. (2020). Clinical practice guidelines: Concepts, limitations and challenges. Medwave, 20(3), Article e7887. https://doi.org/10.5867/medwave.2020.03.7887

Gerry, S. (2020). Early warning scores for detecting deterioration in adult hospital patients: Systematic review and critical appraisal of methodology. BMJ, 369, Article m1501. https://doi.org/10.1136/bmj.m1501

González-Torrente, S., Pericas-Beltrán, J., Bennasar-Veny, M., Adrover-Barceló, R., Morales-Asencio, J. M., & Pedro-Gómez, D. (2012). Perception of evidence-based practice and the professional environment of primary health care nurses in the Spanish context: A cross-sectional study. BMC Health Services Research, 12(1), Article 27. https://doi.org/10.1186/1472-6963-12-27

Habibzadeh, H., Khalkhali, H. R., & Mohamadpor, Y. (2012). The relationship between nurses' quality work-life and their clinical competency. Journal of Urmia Nursing & Midwifery Faculty, 10(3), 332–339.

Hamm, C. W., Bassand, J. P., Agewall, S., Bax, J., Boersma, E., Bueno, H., Caso, P., Dudek, D., Gielen, S., Huber, K., Ohman, M., Petrie, M. C., Sonntag, F., Uva, M. S., Storey, R. F., Wijns, W., Zahger, D., & ESC Committee for Practice Guidelines. (2011). ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal, 32(23), 2999–3054. https://doi.org/10.1093/eurheartj/ehr236

Heery, S., Gibson, I., & Dunne, D. (2019). The role of public health nurses in risk factor modification within a high-risk cardiovascular disease population in Ireland – A qualitative analysis. European Journal of Cardiovascular Nursing, 18(7), 606–614. https://doi.org/10.1177/1474515119850072

Hertz, J. T., Kweka, G. L., Manavalan, P., Watt, M. H., & Sakita, F. M. (2020). Provider-perceived barriers to diagnosis and treatment of acute coronary syndrome in Tanzania: A qualitative study. International Health, 12(2), 148–154. https://doi.org/10.1093/inthealth/ihz061

Hitchcock, M., Gillespie, B., Crilly, J., & Chaboyer, W. (2014). Triage: An investigation of the process and potential vulnerabilities. Journal of Advanced Nursing, 70(7), 1532–1541. https://doi.org/10.1111/jan.12304

Ibanez, B., James, S., Agewall, S., Antunes, M. J., Bucciarelli-Ducci, C., Bueno, H., Caforio, A., Crea, F., Goudevenos, J. A., Halvorsen, S., Hindricks, G., Kastrati, A., Lenzen, M. J., Prescott, E., Roffi, M., Valgimigli, M., Varenhorst, C., Vranckx, P., Widimský, P., … ESC Scientific Document Group. (2018). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal, 39(2), 119–177. https://doi.org/10.1093/eurheartj/ehx393

Ilbashir, H., & Elfaki, B. (2016). Determination of nurses’ knowledge about initial drugs used during emergency management of acute myocardial infarction. Journal of Nursing Education and Practice, 7(5), 62–67. https://doi.org/10.5430/jnep.v7n5p62

Istomina, N., Suominen, T., Razbadauskas, A., Martinkėnas, A., Meretoja, R., & Leino-Kilpi, H. (2011). Competence of nurses and factors associated with it. Medicina, 47(4), Article 33. https://doi.org/10.3390/medicina47040033

Jahromi, M. K. (2020). Comparing the effect of simulated patients and lecture training methods in the clinical self-efficacy of nurses caring for patients with acute coronary syndrome. Acta Medica Iranica, 58(7), 346–352. https://doi.org/10.18502/acta.v58i7.4423

Jarvis, S., & Saman, S. (2017). Diagnosis, management and nursing care in acute coronary syndrome. Nursing Times, 113(3), 31–35.

Karadkar, G., Dasila, P., Deshpande, A., & Kambli, S. V. (2018). Nurses knowledge regarding acute coronary syndrome. International Journal of Recent Scientific Research, 9(12), 29838–29841. https://doi.org/10.24327/ijrsr.2018.0912.2941

Kaul, P., Armstrong, P. W., Sookram, S., Leung, B. K., Brass, N., & Welsh, R. C. (2011). Temporal trends in patient and treatment delay among men and women presenting with ST-elevation myocardial infarction. American Heart Journal, 161(1), 91–97. https://doi.org/10.1016/j.ahj.2010.09.016

Khan, R., Zarak, M. S., Munir, U., Ahmed, K., & Ullah, A. (2020). Thrombolysis in Myocardial Infarction (TIMI) risk score assessment for complications in acute anterior wall ST-elevation myocardial infarction. Cureus, 12(6), Article e8646. https://doi.org/10.7759/cureus.8646

Khojastehfar, S., Najafi Ghezeljeh, T., & Haghani, S. (2020). Factors related to knowledge, attitude, and practice of nurses in intensive care unit in the area of pressure ulcer prevention: A multicenter study. Journal of Tissue Viability, 29(2), 76–81. https://doi.org/10.1016/j.jtv.2020.02.002

King Saud University Medical City. (2020). Staff nurses: Job description.

Lakshmi, K. N. (2018). A study to assess the level of knowledge regarding assessment and management of myocardial infarction among nursing staff in selected hospital at Mysore. JOJ Nursing & Health Care, 8(5), Article 555750. https://doi.org/10.19080/JOJNHC.2018.08.555750

Lee, J. Y., Oh, S. H., Peck, E. H., Lee, J. M., Park, K. N., Kim, S. H., & Youn, C. S. (2011). The validity of the Canadian Triage and Acuity Scale in predicting resource utilization and the need for immediate life-saving interventions in elderly emergency department patients. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 19, Article 68. https://doi.org/10.1186/1757-7241-19-68

Morone, N. E., & Weiner, D. K. (2013). Pain as the fifth vital sign: Exposing the vital need for pain education. Clinical Therapeutics, 35(11), 1728–1732. https://doi.org/10.1016/j.clinthera.2013.10.001

Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., de Ferranti, S., Després, J. P., Fullerton, H. J., Howard, V. J., Huffman, M. D., Judd, S. E., Kissela, B. M., Lackland, D. T., Lichtman, J. H., Lisabeth, L. D., Liu, S., Loucks, E. B., Ma, J., … American Heart Association Statistics Committee and Stroke Statistics Subcommittee. (2015). Heart disease and stroke statistics—2015 update: A report from the American Heart Association. Circulation, 131(4), e29–e322. https://doi.org/10.1161/CIR.0000000000000152

National Institute for Health and Care Excellence. (2010). Unstable angina and NSTEMI: The early management of unstable angina and non-ST-segment-elevation myocardial infarction (NICE Clinical Guideline CG94). https://www.nice.org.uk/guidance/cg94

Nibbelink, C. W., & Brewer, B. B. (2018). Decision-making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917–928. https://doi.org/10.1111/jocn.14151

Nikolaou, N. I., Arntz, H. R., Bellou, A., Beygui, F., Bossaert, L. L., & Cariou, A. (2015). European Resuscitation Council Guidelines for Resuscitation 2015: Section 8. Initial management of acute coronary syndromes. Resuscitation, 95, 264–277. https://doi.org/10.1016/j.resuscitation.2015.07.030

Nofal, A., Alfayyad, I., Khan, A., Al Aseri, Z., & Abu-Shaheen, A. (2018). Knowledge, attitudes, and practices of emergency department staff towards disaster and emergency preparedness at tertiary health care hospital in central Saudi Arabia. Saudi Medical Journal, 39(11), 1123–1129. https://doi.org/10.15537/smj.2018.11.23026

O’Connor, R. E., Al Ali, A. S., Brady, W. J., Ghaemmaghami, C. A., Menon, V., O’Neill, B. J., Travers, A. H., & Zaritsky, A. L. (2015). Part 9: Acute coronary syndromes: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 132(18_suppl_2), S483–S500. https://doi.org/10.1161/CIR.0000000000000263

O'Gara, P. T., Kushner, F. G., Ascheim, D. D., Casey, D. E., Jr., Chung, M. K., de Lemos, J. A., Ettinger, S. M., Fang, J. C., Fesmire, F. M., Franklin, B. A., Granger, C. B., Krumholz, H. M., Linderbaum, J. A., Morrow, D. A., Newby, L. K., Ornato, J. P., Ou, N., Radford, M. J., Tamis-Holland, J. E., ... Zhao, D. X. (2013). 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: Executive summary: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 127(4), 529–555. https://doi.org/10.1161/CIR.0b013e3182742c84

O'Neill, L., Smith, K., Currie, P., Elder, D., Wei, L., & Lang, C. (2014). Nurse-led Early Triage (NET) study of chest pain patients: A long-term evaluation study of a service development aimed at improving the management of patients with non-ST-elevation acute coronary syndromes. European Journal of Cardiovascular Nursing, 13(3), 253–260. https://doi.org/10.1177/1474515113488026

Ozdemir, N. G. (2019). The development of nurses’ individualized care perceptions and practices: Benner’s novice to expert model perspective. International Journal of Caring Sciences, 12(2), 1279–1285.

Pagidipati, N. J., & Peterson, E. D. (2016). Acute coronary syndromes in women and men. Nature Reviews Cardiology, 13(8), 471–480. https://doi.org/10.1038/nrcardio.2016.89

Patel, A., Mohanan, P. P., Prabhakaran, D., & Huffman, M. D. (2017). Pre-hospital acute coronary syndrome care in Kerala, India: A qualitative analysis. Indian Heart Journal, 69(1), 93–100. https://doi.org/10.1016/j.ihj.2016.07.008

Pieszko, K., & Burchardt, P. (2019). Predicting long-term mortality after acute coronary syndrome using machine learning techniques and hematological markers. Disease Markers, 2019, Article 9056402. https://doi.org/10.1155/2019/9056402

Pool, I. A., Poell, R. F., Berings, M. G., & ten Cate, O. (2015). Strategies for continuing professional development among younger, middle-aged, and older nurses: A biographical approach. International Journal of Nursing Studies, 52(5), 939–950. https://doi.org/10.1016/j.ijnurstu.2015.02.004

Pueyo-Garrigues, M., Pardavila-Belio, M. I., Canga-Armayor, A., Esandi, N., Alfaro-Díaz, C., & Canga-Armayor, N. (2022). Nurses' knowledge, skills and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional study. Nurse Education in Practice, 58, Article 103277. https://doi.org/10.1016/j.nepr.2021.103277

Qureshi, N. A. (2010). Triage systems: A review of the literature with reference to Saudi Arabia. Eastern Mediterranean Health Journal, 16(6), 690–698. https://doi.org/10.26719/2010.16.6.690

Roth, G. A., Johnson, C., Abajobir, A., Abd-Allah, F., Abera, S. F., Abyu, G., Ahmed, M., Aksut, B., Alam, T., Alam, K., Alla, F., Alvis-Guzman, N., Amrock, S., Ansari, H., Ärnlöv, J., Asayesh, H., Atey, T. M., Avila-Burgos, L., Awasthi, A., … Murray, C. J. L. (2017). Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. Journal of the American College of Cardiology, 70(1), 1–25. https://doi.org/10.1016/j.jacc.2017.04.052

Ryan, K., Greenslade, J., Dalton, E., Chu, K., Brown, A. F., & Cullen, L. (2016). Factors associated with triage assignment of emergency department patients ultimately diagnosed with acute myocardial infarction. Australian Critical Care, 29(1), 23–26. https://doi.org/10.1016/j.aucc.2015.05.001

Sanchis-Gomar, F., Perez-Quilis, C., Leischik, R., & Lucia, A. (2016). Epidemiology of coronary heart disease and acute coronary syndrome. Annals of Translational Medicine, 4(13), Article 256. https://doi.org/10.21037/atm.2016.06.33

Sanders, S., & DeVon, H. A. (2016). Accuracy in ED triage for symptoms of acute myocardial infarction. Journal of Emergency Nursing, 42(6), 496–502. https://doi.org/10.1016/j.jen.2016.05.011

Saudi Heart Association. (2020). National clinical practice guidelines for the diagnosis and management of acute coronary syndrome. https://saudi-heart.com/wp-content/uploads/2020/12/Clinical-practice-guidelines.pdf

Sławska, A., & Siudak, Z. (2021). Nurse-managed education: The effectiveness of secondary prevention after acute coronary syndromes and the prevalence and predictors of dropout from a cardiac rehabilitation program. Advances in Interventional Cardiology, 17(1), 46–53. https://doi.org/10.5114/aic.2021.104767

Smith, J. N., Negrelli, J. M., Manek, M. B., Hawes, E. M., & Viera, A. J. (2015). Diagnosis and management of acute coronary syndrome: An evidence-based update. Journal of the American Board of Family Medicine, 28(2), 283–293. https://doi.org/10.3122/jabfm.2015.02.140189

Soontorn, T., Sitthimongkol, Y., Thosingha, O., & Viwatwongkasem, C. (2018). Factors influencing the accuracy of triage by registered nurses in trauma patients. Pacific Rim International Journal of Nursing Research, 22(2), 120–130.

Takase, M. (2013). The relationship between the levels of nurses’ competence and the length of their clinical experience: A tentative model for nursing competence development. Journal of Clinical Nursing, 22(9-10), 1400–1410. https://doi.org/10.1111/jocn.12038

Thygesen, K., Alpert, J. S., Jaffe, A. S., Simoons, M. L., Chaitman, B. R., White, H. D., Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, Katus, H. A., Lindahl, B., Morrow, D. A., Clemmensen, P. M., Johanson, P., Hod, H., Underwood, R., Bax, J. J., Bonow, R. O., Pinto, F., Gibbons, R. J., Fox, K. A., … Mendis, S. (2012). Third universal definition of myocardial infarction. Circulation, 126(16), 2020–2035. https://doi.org/10.1161/CIR.0b013e31826e1058

Tierney, S., Cook, G., Mamas, M., Fath-Ordoubadi, F., Iles-Smith, H., & Deaton, C. (2013). Nurses' role in the acute management of patients with non-ST-segment elevation acute coronary syndromes: An integrative review. European Journal of Cardiovascular Nursing, 12(3), 293–301. https://doi.org/10.1177/1474515112451555

Vieira, A. C., Bertoncello, K. C. G., Girondi, J. B. R., Nascimento, E. R. P. D., Hammerschmidt, K. S. D. A., & Zeferinho, M. T. (2016). Perception of emergency nurses in using a chest pain assessment protocol. Texto & Contexto - Enfermagem, 25(1), Article e1830014. https://doi.org/10.1590/0104-07072016001830014

Walid, M. S., Donahue, S. N., Darmohray, D. M., Hyer, L. A., Jr., & Robinson, J. S., Jr. (2008). The fifth vital sign--what does it mean? Pain Practice, 8(6), 417–422. https://doi.org/10.1111/j.1533-2500.2008.00222.x (Retraction published 2009, Pain Practice, 9[3], 245)

Wang, T. J. (2011). Assessing the role of circulating, genetic, and imaging biomarkers in cardiovascular risk prediction. Circulation, 123(5), 551–565. https://doi.org/10.1161/CIRCULATIONAHA.109.912568

Weeks, J. C. (2017). Are emergency department triage nurses knowledgeable about acute coronary syndromes recognition? (Publication No. 10266014) [Doctoral dissertation, Walden University]. ProQuest Dissertations & Theses Global.

WHO CVD Risk Chart Working Group. (2019). World Health Organization cardiovascular disease risk charts: Revised models to estimate risk in 21 global regions. The Lancet Global Health, 7(10), e1332–e1345. https://doi.org/10.1016/S2214-109X(19)30318-3

World Health Organization. (2016). Noncommunicable diseases country profiles 2016. World Health Organization. https://apps.who.int/iris/handle/10665/250220

World Health Organization. (2018, June 11). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds

Downloads

Published

2026-08-09

How to Cite

Mancenido , V. (2026). Early Recognition and Management Skills of Emergency Department Nurses in Handling Acute Coronary Syndrome. International Journal of Education, Research, and Innovation Perspectives, 2(8), 553-573. https://doi.org/10.5281/zenodo.21862346

Similar Articles

41-50 of 427

You may also start an advanced similarity search for this article.