Analysis of a Research Report - Evaluation of the Act Intervention to Improve Nurses' Cardiac Triage Decision

Analysis of a Research Report

In the article, Evaluation of the ACT Intervention to Improve Nurses' Cardiac Triage Decisions, the problem is that only about 25% of the patients with acute chest pain receive an ECG within ten minutes of arrival to the Emergency Department (ED). "The purpose of this study was to evaluate the preliminary effectiveness of the Aid to Cardiac Triage (ACT) intervention to improve ED nurses' cardiac triage decisions by determining the association between the ACT intervention and women receiving an initial physician-read ECG within 10 minutes of ED arrival as recommended by the ACC/AHA MI guidelines" (Arslanian-Engoren, Hagerty, & Eagle, 2010)

. The study primarily addresses the symptoms in women over the age of 18. The study used as its framework the four-phase model of ED patient care promulgated by Rhee, Donabedian, and Burney (1987). This model is consistent with the ACC/AHA guidelines. Many of the citations in the article were dated within the past six to seven years, which make the references current. This article cited 43 references. These authors noted that no study was found that focused exclusively on improving the cardiac triage decisions of ED nurses. Nurses are typically the first provider to see a patient and in this study specifically women with chest pain.

The study used an ED in western Michigan. This ED evaluated more than 850 women per year with signs and symptoms of MI/ACS. The charts of the women patients had received an ECG in the ED three months prior to the ACT training. The women were over the age of 18. The study then looked at ECGs of women three months post ACT training.

The measures included patients age, time of arrival in the ED, the time of the RN triage decision, the time the doctor read the ECG, presenting symptoms, medical history, and current medications. The variables considered for inclusion as predicts were selected based on published literature and empirical evidence. The study measured whether or not the ECG was obtained within 10 minutes of arrival. It also measured whether or not the patient used the complaint of chest pain, pressure, discomfort, squeezing, or heaviness.

Another variable to the study was the patient's age. The study used a continuous and a categorical variable and divided the patients into four age groups; 18 to 44, 57 to 73 and 74 or greater. Each group had an equal number of patients. The independent variables were time of arrival, patient's age, and the patient's present complaint.

A dependent variable is all had to present to the ED. The study excluded any women who had arrived by ambulance, had any acute traumatic injury, or did not receive an ECG in the department. The demographic variables were age and gender.

The design of this study was a quasi-experimental, one-group pretest-posttest design quasi-experiment