Nursing
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Item Triage of patients with acute coronary syndrome at the emergency department: A retrospective study(2023-01-30) Kmetec, Sergej; Fekonja, Zvonka; Markež, Urša; McCormack, Brendan; Fekonja, Urška; Strnad, Matej; Lorber, MatejaBackground: Acute coronary syndrome represents a considerable challenge worldwide as one of the causes of death; its diagnosis is often very complex. It includes acute myocardial infarction with ST-segment elevation, acute myocardial infarction without ST-segment elevation, unstable angina pectoris, and sudden cardiac arrest. Methods: This retrospective cohort study included 678 patients who were admitted to the emergency department between 2015 and 2019 with acute coronary syndrome. Triage data were reviewed for vital signs, baseline characteristics, chief complaints, demographic variables, mode and time of arrival, triage, diagnosis, and treatment. Regression was used to identify key symptoms and patient characteristics at triage encounter to predict acute coronary syndrome. Results: A total of 678 triage records were identified. The average age of the sample was 67 years old, 58.6% male, and 31.8% came by themselves to the emergency department. The most common diagnosis was acute myocardial infarctions without ST elevation (38.2%). Chest pain and difficulty in breathing were the two most common symptoms. Most patients were not assigned to the appropriate triage category, i.e., were diagnosed as less urgent. Discussion and conclusion: This study presents the triage of patients with acute coronary syndrome at the emergency department to provide a comprehensive insight into their care. By identifying patient symptoms at the emergency department, nurse triage recognizes patients with acute coronary syndrome on time, thus increasing the accuracy of determining the triage category, which will impact the treatment outcome of patients. ©2023 the author(s), published by De Gruyter. All rights reserved.Item Palliative care for patients with heart failure: a cross-sectional study among nursing healthcare professionals(De Gruyter, 2023-01-30) Kmetec, Sergej; Fekonja, Zvonka; Gönc, Vida; McCormack, BrendanBackground: Acute heart failure is a problem that the public healthcare system faces worldwide. Despite improving healthcare systems and the resulting treatment, the disease's incidence and frequency has increased annually. Therefore, patients with acute heart failure often seek help in the emergency room, where nursing health professionals encounter the condition early or late. In the final stages, they need to focus on providing palliative care to such patients. The chapter aims to determine the nursing healthcare professionals' knowledge, perceptions, and attitudes towards palliative care in patients with heart failure in the emergency and cardiology departments. Methods: A cross-sectional study was carried out. The survey took place in August 2019 involving nursing healthcare professionals. Results: Of 104 nurses, 50% (n = 52) had received training in palliative care throughout their education and 7.7% (n = 8) had received additional training. Nursing healthcare professionals in both the emergency and the cardiology departments have similar knowledge about palliative care. With regard to the perception of implementing palliative care, the data shows a statistically significant difference between both departments. Furthermore, statistically significant differences between the emergency and cardiology departments have been found in some statements regarding their attitudes, namely that there remains a need for palliative care in treating patients with heart failure. Discussion and conclusion: We believe that the knowledge of palliative care in the cardiology and emergency departments is good, and that there are no major differences between the knowledge and departments. However, further training is required to improve the healthcare staff's knowledge, perceptions, and attitudes towards palliative care in patients with heart failure. ©2023 the author(s), published by De Gruyter. All rights reserved.