Determining chest pain patients' suitability for transfer to a general ward following admission to a cardiac care unit.
The objective of this study was to assess the performance of a consensus-derived decision algorithm in determining chest pain patients' suitability for early transfer to a lower dependency ward by predicting complications. The sample comprised 516 patients with chest pain presumed to be cardiac in o...
| Published in: | Journal of Advanced Nursing (Wiley-Blackwell) Vol. 32; no. 2; pp. 310 - 318 |
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| Main Authors: | , , |
| Format: | algorithm equations & formulas research tables/charts Journal Article |
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Wiley-Blackwell
Aug2000
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107136425&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107136425 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03092402 4BG jtl: Journal of Advanced Nursing (Wiley-Blackwell) issn: 03092402 maglogo: Y pubinfo: dt: Aug2000 vid: 32 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 107136425 107136425 5850727 5850727 10.1046/j.1365-2648.2000.01478.x NLM10964177 107136425 ppf: 310 ppct: 8 formats: tig: atl: Determining chest pain patients' suitability for transfer to a general ward following admission to a cardiac care unit. aug: au: Quinn T Thompson DR Boyle RM affil: Honorary Visiting Fellow, Dept of Health Studies, University of York sug: subj: Transfer, Intrahospital Coronary Care Nursing Decision Making, Clinical Clinical Assessment Tools Myocardial Infarction England Coronary Care Units England Outcomes (Health Care) Evaluation Clinical Assessment Tools Evaluation Sensitivity and Specificity Data Analysis Software Record Review Medical Records Myocardial Infarction Complications Cardiac Patients Descriptive Statistics Evaluation Research Nursing Assessment Middle Age Aged Aged, 80 and Over Inpatients Male Female Human Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: The objective of this study was to assess the performance of a consensus-derived decision algorithm in determining chest pain patients' suitability for early transfer to a lower dependency ward by predicting complications. The sample comprised 516 patients with chest pain presumed to be cardiac in origin, admitted to a cardiac care unit (CCU) in northern England from the community or from the accident and emergency department. A decision algorithm was designed following a review of the literature and amended to take into account a clinical consensus of consultant physicians. Patients were assessed on admission by CCU nurses using the algorithm, and 'triage' decisions recorded (keep on CCU or suitable for early transfer to a general ward). Admission ECGs (electrocardiographs) and baseline clinical data were recorded independently by a researcher 'blinded' to actual clinical course, and applied to the algorithm using statistical software. On discharge or death, patients' case notes were retrieved and the hospital course examined for death or severe complications. Performance of the algorithm and CCU nurses were compared for sensitivity, specificity, positive predictive value and negative predictive value. The main outcome measures were death or severe complications occurring during hospitalization, and during the first 2 days following CCU admission. While sensitivity of both the algorithm (0.98) and CCU nurses (0.95) was high, specificity was low in both groups (0.11 and 0.21, respectively), making it unlikely that the algorithm would prove useful in clinical practice. Further studies are required to develop the optimal triage tool for the assessment of patients with acute chest pain. pubtype: Academic Journal doctype: algorithm equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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