Care delays in patients with signs and symptoms of acute myocardial infarction.

AIM: More than six million patients with signs and symptoms suggestive of a heart attack present to emergency departments (EDs) in the US each year. Of those diagnosed with acute myocardial infarction (AMI), one third die in the acute phase. Rapid ED triage can reduce the mortality rate, yet there are still delays in patient care. The aim of this study is to explore the relationship between patient and nurse characteristics, patient presentations, delays in triage, and delays in obtaining electrocardiograms (ECGs) of patients with signs and symptoms of AMI.

METHODS: A retrospective correlational study drawing on data from the records of 286 patients with signs and symptoms of AMI.

RESULTS: Delays in triage are related significantly to patients' gender and race. Most patients were triaged by nurses with associate degrees in nursing, a mean age of 45 and a mean of 18 years' experience. An increase in nurse years of experience predicted greater delay in triage. Delays in obtaining ECGs were also significantly greater with more experienced nurses and when patients reported no chest pain.

CONCLUSION: The study adds to the literature on delays in triage and ECGs in care of patients with possible AMI, and further research of the effects of ED crowding and availability of resources in emergency cardiac care is warranted. Studies should identify the processes that cause delays in the emergency care of patients with signs and symptoms of AMI to ensure timely treatment and care.