We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Clinician assessment of acute coronary syndrome in the emergency department.
- Authors
Chapple, Allyson M; Chuang, Ming-Yu Anthony; Clark, Robyn A; Horsfall, Matthew; Blyth, Andrew; Chew, Derek; Astley, Carolyn
- Abstract
Background: Patients with chest pain represent a large portion of emergency department (ED) presentations around the world. Accurate risk assessment to rule out acute coronary syndrome (ACS) is required. Aim: To measure accuracy and characteristics of ED doctors and nurses when assessing patients for suspected ACS and the associations with outcome. Methods: A sub-analysis of a large randomised trial that compared high-sensitivity troponin to conventional troponin was carried out. Both nurses and doctors conducted ACS risk assessments on 1857 patients and concordance comparisons were undertaken. Findings: There was no difference between the accuracy of ED nurses and doctors (c-statistic: 0.67 vs 0.68 respectively; P=0.35). Both clinician types made similar ACS risk assessments. Nurses with specialist qualifications and consultant doctors were the most accurate, at 65.4% and 74.2%, respectively. Conclusion: Nurses and doctors in the ED made similar ACS risk assessments but both were sub-optimal. Standard clinical pathways to assist ED doctors and nurses improve their ACS impression accuracy could be beneficial.
- Subjects
AUSTRALIA; EMERGENCY nursing; ACUTE coronary syndrome; ANALYSIS of variance; CHI-squared test; CLINICAL competence; STATISTICAL correlation; LENGTH of stay in hospitals; HOSPITAL emergency services; EVALUATION of medical care; MEDICAL consultants; MEDICAL cooperation; MEDICAL specialties &; specialists; PSYCHOLOGY of physicians; QUESTIONNAIRES; RESEARCH; RISK assessment; URBAN hospitals; SECONDARY analysis; DESCRIPTIVE statistics; MANN Whitney U Test; DIAGNOSIS; PSYCHOLOGY
- Publication
British Journal of Cardiac Nursing, 2018, Vol 13, Issue 10, p498
- ISSN
1749-6403
- Publication type
Article
- DOI
10.12968/bjca.2018.13.10.498