title: Effect of gender on evidence-based practice for Australian patients with acute coronary syndrome: A retrospective multi-site study.
abstract: BACKGROUND
  Early acute coronary syndrome (ACS) care occurs in the emergency department (ED). Death and disability from ACS are reduced with access to evidence-based ACS care. In this study, we aimed to explore if gender influenced access to ACS care.
  
  
  METHODS
  A retrospective descriptive study was conducted for 288 (50% women, n=144) randomly selected adults with ACS admitted via the ED to three tertiary public hospitals in Victoria, Australia from 1.1.2013 to 30.6.2015.
  
  
  RESULTS
  Compared with men, women were older (79 vs 75.5 years; p=0.009) less often allocated triage category 2 (58.3 vs 71.5%; p=0.026) and waited longer for their first electrocardiograph (18.5 vs 15min; p=0.001). Fewer women were admitted to coronary care units (52.4 vs 65.3%; p=0.023), but were more often admitted to general medicine units (39.6 vs 22.9%; p=0.003) than men. The median length of stay was 4days for both genders, but women were admitted for significantly more bed days than men (IQR 3-7 vs 2-5; p=0.005).
  
  
  CONCLUSIONS
  There were a number of gender differences in ED care for ACS and women were at greater risk of variation from evidence-based guidelines. Further research is needed to understand why gender differences exist in ED ACS care.
authors.affiliation: Deakin University Centre for Quality and Patient Safety Research, Faculty of Health, Geelong, VIC, 3220, Australia; Deakin University School of Nursing and Midwifery, Faculty of Health, Geelong, VIC, 3220, Australia; Eastern Health-Deakin University Nursing and Midwifery Research Centre, Level 2, 5 Arnold Street, Box Hill, VIC 3128, Australia. Electronic address: lisakuhn@deakin.edu.au.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kuhn
authors.affiliation: Deakin University School of Nursing and Midwifery, Faculty of Health, Geelong, VIC, 3220, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Page
authors.affiliation: Deakin University Centre for Quality and Patient Safety Research, Faculty of Health, Geelong, VIC, 3220, Australia; Deakin University School of Nursing and Midwifery, Faculty of Health, Geelong, VIC, 3220, Australia; Eastern Health-Deakin University Nursing and Midwifery Research Centre, Level 2, 5 Arnold Street, Box Hill, VIC 3128, Australia.
authors.forename: Maryann
authors.initials: M
authors.lastname: Street
authors.affiliation: Deakin University Centre for Quality and Patient Safety Research, Faculty of Health, Geelong, VIC, 3220, Australia; Deakin University School of Nursing and Midwifery, Faculty of Health, Geelong, VIC, 3220, Australia; Disciplines of Nursing & Midwifery, Faculty of Health, University of Canberra, University Drive, Bruce, ACT 2617, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Rolley
authors.affiliation: Deakin University Centre for Quality and Patient Safety Research, Faculty of Health, Geelong, VIC, 3220, Australia; Deakin University School of Nursing and Midwifery, Faculty of Health, Geelong, VIC, 3220, Australia; Eastern Health-Deakin University Nursing and Midwifery Research Centre, Level 2, 5 Arnold Street, Box Hill, VIC 3128, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Considine
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D016009:Chi-Square Distribution; D004562:Electrocardiography / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D055416:Evidence-Based Emergency Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012306:Risk; D012737:Sex Factors; D018709:Statistics, Nonparametric; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014218:Triage / Q000706:statistics & numerical data
keywords: Acute coronary syndrome; Emergency department; Emergency nursing; Evidence-based practice; Myocardial infarction