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Are Triage Nurses Knowledgeable about Acute Coronary Syndromes Recognition?”

Info: 1211 words (5 pages) Nursing Literature Review
Published: 22nd May 2020

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Tagged: ACS

Article Review of  Are Triage Nurse Knowledgeable about  Acute Coronary Syndromes Recognition?

Blood flow suddenly restricted from the heart causes Acute Coronary Syndrome (ACS). According to the American College of Cardiology (ACC) and the American Heart Association (AHA), treating ACS symptoms within 90 minutes of discovery prevents deaths and improves blood flow to the heart.  In addition, emergency departments should administer an electrocardiogram (ECG) to ACS patients within 10 minutes of their assessment (Weeks, Johnson & Jones, 2017). To triage patients correctly, registered nurses must know and identify the differences between non cardiac and acute cardiac symptoms in emergency department patients. Because of delays, nurses need to improve the time it takes to provide immediate treatment for ACS patients entering the emergency department.

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The quantitative study analyzed the nurse’s ability to correctly diagnose and triage emergency department patients with ACS. In the study, the researchers studied 52 nurses at 2 Georgia hospitals. 38 nurses from a large, urban hospital with a cardiac unit and 14 nurses from a small, rural hospital without a cardiac lab volunteered for an open-ended, 12-question exam (Weeks, Johnson & Jones, 2017).  All participants worked in the emergency department for a year or longer and required an 84 percent benchmark grade to pass the exam. All nurses failed the ACR competency test.   However, nurses with more years of emergency room experience scored higher. Nineteen of the nurses worked in the emergency department for more than 8 years.

However, the results could be skewed by the low number of participants and hospitals. Researching a larger number of nurses from different regions would be helpful for comparison. Even, the stress level of nurses taking the test may have caused them to answer incorrectly. Furthermore, multiple choice answers may have hindered the nurses from expanding on their knowledge. Finally, the wording of some of the questions and answers could have been misunderstood. Allowing nurses to write their own answers may have provided different results. Due to the lack of research on acute coronary syndrome and emergency department nurses, data could not be compared.

To improve the response time of ACS patients, emergency departments and hospital administrations must provide continued education, current physiological data, improved ACS guidelines as well as improvements in overcrowded emergency departments and understaffed hospital employees. Current physiological data helped nurses identify ACS symptoms effectively. Women and men do not always show the same symptoms. For example, many female patients exhibit shortness of breath, fatigue, and nausea instead of the traditional, male symptoms of chest pain, left arm pain, and sweating. In the past, triage nurses used traditional symptoms as the main data points to determine ACS urgency (Weeks, Johnson & Jones, 2017). In addition, the ACA national guidelines for ACS care, currently in place, cost $21,000; therefore, most emergency departments do not purchase them (Weeks, Johnson & Jones, 2017). However, the ACA provides ACS education classes for all nurses. Problems in other areas of the emergency department prevent some nurses from performing their duties effectively. For example, other conditions that cause inefficiency in response time include patient overcrowding, inadequate staffing, poor working conditions, and overworked physicians (Week, Johnson & Jones, 2017). It is imperative that hospital administrators require ACS guidelines that help determine symptoms early in emergency departments. In conclusion, the importance of triage nurses learning the difference between non cardiac and acute cardiac symptoms in emergency department patients requires dedication, continued education, and ACS training

The knowledge I gained about assessing patients accurately in the triage area of the emergency department helped me understand the importance of patient care. 68 percent of emergency department nurses failed to take continuing education classes according to the research study by S. Sanders and H. DeVon (Weeks, Johnson & Jones, 2017). Registered nurses must rely on critical thinking, educational training, skill, and patient care when performing their job.  J. Hollander and M. Chase indicated six million people visit the emergency department because of chest pain every year; therefore, knowledge of heart related symptoms helps nurses accurately aid in a patient’s health.  350,000 of those patients die, and some of their deaths have a direct link to the amount of time it takes to open their coronary artery from the start of the patient’s symptoms (Weeks, Johnson & Jones, 2017). Emergency departments must train triage nurses to recognize ACS in patients.

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The information from this article provided the importance to learn the difference between non cardiac and acute cardiac symptoms in patients. In the emergency room, time is the biggest factor in restoring or preventing blood flow to the heart. Since the signs and symptoms of heart patients will vary, the care provided must be individualized to each patient. ACS manifests itself differently in people, so a head to toe assessment, medical history and patient communication must be performed accurately in triage. However, the efficiency of emergency departments depends on more than the ability of nurses to perform their jobs accurately. Therefore, the effectiveness of an ACS patient to be treated immediately may not be the fault of the triage nurse. Fortunately, most caregivers want to provide the best care possible for their patients.

The research in this article can be applied to general nursing practices in many ways. Staying up to date with training processes, guidelines, and education in all nursing fields will prevent nurses from missing signs and symptoms that could lead to more damage or be fatal.  Understanding ACS in patients may provide a positive result and healthier heart. The importance of nurses learning the difference between non cardiac and acute cardiac symptoms in emergency department patients requires dedication, continued education, and improvements in ACS guideline information for all emergency departments. To increase the blood flow to the heart, triage nurses must treat ACS patients immediately.


  • Weeks, Jennifer, Johnson, Joyce, & Jones, Edna. (2017) Are triage nurse knowledgeable about acute coronary syndromes recognition? The ABNF Journal, Summer, 2017.
  • Weeks, C., J. (April 2017). Are triage nurse knowledgeable about acute coronary syndromes recognition? Department of Nursing, College of Sciences and Health Professions, Albany State University. Retrieved from https://ramscholar.dspace-express.com/bitstream/handle/10675.1/620164/J%20Weeks%20ACS%20Thesis%20rev.%204.19.17.pdf?sequence=1&isAllowed=y


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Acute coronary syndrome (ACS) describes any condition relating to the heart where there is a lack of blood flow or a blockage of blood to the heart muscles. Some conditions that are included under this umbrella are a myocardial infarction (MI), otherwise known as a heart attack and unstable angina.

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