Patient cues that predict nurses' triage decisions for acute coronary syndromes.
The purpose of this study was to determine the patient cues that emergency department (ED) nurses use to triage male and female patients with complaints suggestive of acute coronary syndromes (ACSs) and to determine if cues used by ED nurses to make clinical inferences varied by patient sex or nurses' demographic characteristics. Using clinical vignette questionnaires with different patient characteristics, ED nurses' triage decisions were evaluated to determine the patient cues used to predict ACS. Men and women were equally likely to be given an ACS triage decision and this was not affected by nurses' demographic characteristics. However, nurses used different cues to triage men and women with complaints suggestive of ACS, although by receiver operating characteristic curves, the differences between sexes were small. In addition, female vignette patients were more likely than male vignette patients to be assigned a suspected cause of cholecystitis for their presentation in a small subset of 13 (11:2; odds ratio, 1.653; 95% confidence interval, 1.115-24.47; p=.036). This study provides insight into the complex phenomenon of triage decision making and warrants further exploration.
Division of Acute, Chronic, and Long-Term Care, University of Michigan School of Nursing, Ann Arbor 48109, USA. cmae@umich.edu
Cynthia
C
Arslanian-Engoren
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D002568:Certification; D002983:Clinical Competence; D003327:Coronary Disease / Q000175:diagnosis* / Q000451:nursing; D003463:Cues; D003657:Decision Making; D004522:Educational Status; D016529:Emergency Nursing / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D009730:Nursing Assessment / Q000379:methods*; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012727:Sex Characteristics; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014218:Triage / Q000379:methods*