Coronary Care Unit Nurses Research Articles

Determination of Coronary Care Unit Nurses' Knowledge Regarding Patient Rehabilitation After Myocardial Infarction

Background: Cardiovascular disease (CVD) is the number one cause of death worldwide. Objective: To determine of coronary care unit nurses' knowledge regarding patient rehabilitation after myocardial infarction. Methodology: A cross- sectional study was designed in the Cardiac Care Unit of Al-Diwaniyah Teaching Hospital and the Specialized Center for Cardiac Surgery and Catheterization for the period from (November 7, 2022) to (May 12, 2023). A non-probability (purposive) sample consisting of (75 nurses) working in the above-mentioned study site. To determination of coronary care unit Nurses' knowledge regarding patient rehabilitation after myocardial infarction, the researcher used a tool that consists of two parts: The first part: is the demographic data of the study sample, and the second part: nurses' knowledge about patient rehabilitation after myocardial infarction includes 28 items. Results: The study showed that (48%) of the nurses in the study sample had fair levels of knowledge regarding patient rehabilitation after myocardial infarction. It also showed that there is a statistically significant relationship between the nurses' knowledge and their age. Conclusion: The current study concluded that the largest percentage of the participants in the study have fair knowledge about patient rehabilitation after myocardial infarction, while a small number of them have satisfactory knowledge.

Towards the Provision of Palliative Care Services in the Intensive Coronary Care Units: Nurses' Knowledge, Training Needs, and Related-Barriers.

Despite the notable benefits of palliative care (PC) for patients with chronic diseases, its delivery to people with cardiac problems, particularly in the Middle East region (EMR), remains a critical issue. There is a scarcity of research assessing nursing staff's needs and knowledge in providing PC to cardiac patients in the EMR. This study aimed to assess the level of knowledge and needs of PC among nurses towards the provision of PC in intensive coronary care units (ICCUs) in the Gaza Strip, Palestine. It also identified the barriers to the provision of PC services in ICCUs in the Gaza Strip. A hospital-based descriptive quantitative cross-sectional design was adopted to collect data from 85 nurses working in ICCUs at four main hospitals in the Gaza Strip. Knowledge about PC was collected using a developed questionnaire based on the Palliative Care Quiz Nursing Scale (PCQN) and Palliative Care Knowledge Test (PCKT). PC training needs and barriers were assessed using the PC Needs Assessment instrument. Approximately two-thirds of nurses did not receive any PC educational or training programs, which contributed to their lack of PC knowledge. Most nurses would like to enroll in PC training programs, such as family support and communications skills courses. Nurses reported that there was a high demand for PC guidelines and discharge planning for patients with chronic illnesses. Insufficient healthcare professionals' knowledge about PC and a staff shortage were the main barriers to integrating PC into the Gaza healthcare system. This study suggests incorporating PC into nursing curricula and in-service training, and it covers both basic and advanced PC principles. Intensive coronary care unit nurses need knowledge and training about PC, guidance, and support to provide appropriate care to patients with cardiovascular issues.

Usability Study on Patient Monitoring Systems: An Evaluation of a User Interface Based on User Experience and Preference.

BACKGROUND The poor ergonomic design of patient monitoring systems can cause user errors and patient harm. This paper presents the results of a comparative usability study based on user experience and the results of a user preference survey. MATERIAL AND METHODS We conducted a usability study of 3 patient monitoring systems: Mediana M50, Philips IntelliVue MP70, and Philips IntelliVue MX700. Thirty-nine Coronary Care Unit nurses and 19 Pulmonology and Allergy Care Unit nurses participated in this usability study. User experience was assessed with the Post-Study System Usability Questionnaire and the National Aeronautics and Space Administration Task Load Index. A user preference survey was conducted to evaluate the subjective medical device design preferences for the M50 system's user interface. RESULTS Nurses from the Coronary Care Unit recognized a higher system usability for the MP70 than the M50 (P=0.001) system, and a lower workload for the MP70 compared with the M50 (P=0.005) system. There was no significant (P>0.05) difference in perceived system usability and workload between the M50 and MX700 systems for the nurses from the Pulmonology and Allergy Care Unit. Nurses preferred to activate the arrhythmia alarms except for the ST alarms and missed the beat alarm. They also preferred having a wave freeze function, standby mode, and early warning scoring function, which provides a signal for a patient's deterioration in health. CONCLUSIONS The study provides valuable data on a user interface evaluation based on user experience and preference. The outcome of this study will be helpful for designing next-generation patient monitors with improved patient safety.

Coronary Care Unit Nurses’ Experiences of Care Management Self-Efficacy: A Qualitative Content Analysis

Recognizing various aspects of the self-efficacy concept in specialized medical units such as intensive care units (ICUs) and coronary care units (CCUs) has the potential to help nurses improve their quality of care. Therefore, we conducted a qualitative content analysis study in 2018 in hospitals of the Guilan Province, northern Iran, to help explain nurses’ perceptions of self-efficacy in care management within CCU wards. Thirty-four semi-structured interviews were conducted with nurses from CCUs. Using Graneheim and Lundman’s (2004) analytical techniques, we extracted three main themes and nine sub-themes from the data: decline in self-efficacy (e.g., time constraint, high work pressure, emotional stresses, and loss of motivation); care development (e.g., experience-based care, knowledge-based care, and personal capability); and organizational challenges (e.g., weak management and unavailable physician). Our findings suggest that decreases in nurse self-efficacy (and resulting weak care management) could be prevented by establishing clear plans and enrolling nurses into appropriate training courses. The constant development of knowledge and experience alongside supportive supervisors and physicians are also effective in improving nurses’ self-efficacy.

Compassion Fatigue in Nurses: The Role of Spiritual Well-Being, Emotion Regulation and Time Perspective.

Nurses experience many psychological problems in the coronavirus disease 2019 (COVID-19) outbreak. This study aimed to investigate the prevalence of Compassion Fatigue (CF) in nurses and the role of Spiritual Well-being (SW), Emotion Regulation (ER), and Time Perspective (TP) in predicting it. The research method was descriptive-correlational. The statistical samples of this study included 394 nurses in Iran who were selected by the census sampling method. The sub-scale of CF from the Professional Quality of Life Scale, SW questionnaire, ER, and the short form of TP questionnaires were used to collect data. Descriptive statistics and analysis of covariance tests were used to analyze the data. The prevalence of CF in nurses in the COVID-19 outbreak was 59.39%. CF in female nurses was higher than that in male nurses (F3,392 = 15.23, p < 0.001); in married nurses, it was higher than that in single nurses (F3,392 = 14.23, p < 0.001); and in nurses on fixed shifts, it was higher than that in nurses on rotating shifts (F3,392 = 5.63, p < 0.001). Also, CF in the emergency nurses, intensive care unit nurses, and coronary care unit nurses working under COVID-19 pandemic was higher than that in the emergency nurses and nurses who worked in other wards (F3,388 = 14.31, p < 0.001). The results of hierarchical regression showed that SW, ER, and positive past negatively and suppression, present-fatalistic, negative past, and negative future positively predicted the CF (p < 0.001). Based on the results, programs and psychological trainings based on SW, ER, and TP are suggested to reduce CF in nurses in the COVID-19 outbreak.

Barriers to the Development of Clinical Reasoning Skills among Coronary Care Nurses: A Qualitative Study.

Clinical Reasoning (CR) is a main professional competency for nurses which have significant contribution to sound clinical performance in critical clinical conditions. Nonetheless, evidence shows that nurses do not have the necessary competencies and thinking skills for managing complex conditions in critical care units. This study aimed at exploring the barriers to the development of CR skills among coronary care nurses. Using conventional content analysis, this qualitative study was conducted in 2020 in the Coronary Care Unit (CCU) of Heshmat Subspecialty Heart Center in Rasht, Iran. Participants were 15 nurses, head nurses, nursing supervisors, nursing managers, and nursing instructors. Data were collected using semi-structured interviews and were analyzed using conventional content analysis. The four main categories of the barriers to CR skill development among nurses were limited professional development, inefficient educational program, ineffective professional interactions, and limited professional self-efficacy. There are different personal, educational, professional, and interprofessional barriers to the development of CR skills among CCU nurses. Study findings can be used to develop effective strategies for supporting and developing nurses' CR skills.

THE RETURN OF SUBCLAVIAN CANNULATION IN THE CRITICAL CARE SETTING: A WESTERN CRITICAL CARE EXPERIENCE

THE RETURN OF SUBCLAVIAN CANNULATION IN THE CRITICAL CARE SETTING: A WESTERN CRITICAL CARE EXPERIENCE

Assessment of Nurse’s Knowledge Concerning nursing care of the patients receiving thrombolytic therapy with Acute Myocardial Infraction at Coronary Care Unit in Al-Diwaniya Teaching Hospital

Background: Cardiovascular disease is a group of disorders that occur in the heart and blood vessels. Coronary artery disease is a condition that develops due to the accumulation of atherosclerotic plaque in the pericardial coronary arteries leading to myocardial ischemia. Acute myocardial infarction is a severe type of coronary artery disease that occurs from blocked of arteries in the heart, and occurrence of acute myocardial infarction is growing steadily due to increased alcohol and cigarettes, stress. Diagnostic methods for discovery the patients with acute myocardial infarction are electrocardiogram and markers of the heart muscle necrosis, and myocardial perfusion to reduce mortality by thrombolytic therapy or percutaneous coronary intervention. Thrombolytic therapy is used to treat acute myocardial infarction, which is the dissolution of a blood vessel clot of the heart by converting plasminogen into plasmin. It is most effective if it is delivered within three hours of the onset of symptoms.Aims of the study: to assess of nursesꞌ knowledge about nursing care of patients receiving thrombolytic therapy with Acute Myocardial Infarction at Coronary Care Unit.Methodology: A quantitative descriptive cross-sectional design was used in order to achieve objectives of this study was carried out at AL-in Al-Diwaniya Teaching Hospital for the period (17th September, 2020 to 4th April, 2021) on a total population sample consisting of (40 nurses) working in Coronary Care Unit.Results: The results of this study show that nurses' knowledge for Nursing Management of Thrombolytic Therapy for Patients with Acute Myocardial Infraction domains were low at mean score (1.26) and no significant association between knowledge of nurses and selected variables (p&gt;0.05).Conclusion: The nursesꞌ knowledge had low about Nursing Care of Thrombolytic Therapy at Coronary Care Unit.Recommendations: The study recommended that can participating all coronary care unit nurses in special educational program and encouraging to improvement knowledge about nursing management of thrombolytic therapy in the Coronary Care Unit.

What's in this Special Issue

What's in this Special Issue

Effects of training on knowledge and attitudes of coronary care unit nurses in relation to teamwork: A quasi-experimental study

Teamwork has special significance in patient safety and quality of care in the coronary care units (CCUs). This study aimed to determine the impact of training on attitudes and knowledge of CCU nurses about teamwork. This quasi-experimental study was conducted in the CCUs of Al-Zahra Cardiovascular Hospital, Shiraz, Iran. Participants included 70 nurses with a mean age of 31.33±4.56 years. They were divided into experimental and control groups. Data were collected at the baseline and one month after an intervention using a teamwork knowledge test and Teamwork Attitude Questionnaire. The intervention involved a 4-hour workshop on teamwork. Data were analyzed via SPSS 16.0, using descriptive statistics, chi-square, paired t-test, and independent samples t-test. The mean overall teamwork attitude score of the experimental group following intervention (125.5±12.56) had statistically significant differences from the baseline (110.4±12.6) and the mean score of the control group (112.11±15.17) (P<.001). Furthermore, the mean scores of attitude dimensions improved significantly, except for mutual support and situation monitoring. In addition, in relation to teamwork knowledge, the experimental group had a significantly higher mean score after the intervention (18.6±4.35) compared with the baseline (13.14±4.25) and the control group (14.8±4.07) (P<.001). Training improved knowledge and attitudes of CCU nurses in relation to teamwork. Considering the critical role of mutual support and situation monitoring in nursing performance, we should place more emphasis on them in nursing education and practice. TRIAL REGISTRATION: IRCT2016080123199N2. Date registered 2016-09-22.

Appointing nurses trained in organ donation to improve family consent rates

BackgroundOne of the most important bottlenecks in the organ donation process worldwide is the high family refusal rate.Aims and objectivesThe main aim of this study was to examine whether family guidance by trained donation practitioners increased the family consent rate for organ donation.DesignThis was a prospective intervention study.MethodsIntensive and coronary care unit nurses were trained in communication about donation (ie, trained donation practitioners) in two hospitals. The trained donation practitioners were appointed to guide the families of patients with a poor medical prognosis. When the patient became a potential donor, the trained donation practitioner was there to guide the family in making a well‐considered decision about donation. We compared the family consent rate for donation with and without the guidance of a trained donation practitioner.ResultsThe consent rate for donation with guidance by a trained donation practitioner was 58.8% (20/34), while the consent rate without guidance by a trained donation practitioner was 41.4% (41/99, P = 0.110) in those patients where the family had to decide on organ donation.ConclusionsOur data suggest that family guidance by a trained donation practitioner could benefit consent rates for organ donation.Relevance to clinical practiceTrained nurses play an important role in supporting the families of patients who became potential donors to guide them through the decision‐making process after organ donation request.

Factors Influencing Job Satisfaction and Turnover Intention among Coronary Care Unit Nurses in Bahrain

Background: At a time of worldwide nursing shortage, is raising questions about the issue of increasing nurses' turnover. The literatures have shown that stronger intention to leave as a consequence of job dissatisfaction may lead to actual turnover. Therefore, it may be a crucial to understand nurses' job satisfaction issue, as this is a key factor in nurses' intention to leave the working place and low job commitment. Aim and Objective: This study examined the factors that determine job satisfaction which are personal, environmental and organizational components and the relation of those factors on Coronary Care Unit nurses' intention to leave their working place. Methodology/ Design: Across sectional, quantitative and correlation design was selected at a fixed point in time. Method: Data was drawn from analysis of self reported questionnaire which included three sections of; demographic data, McClosky Mueller Satisfaction Scale and Anticipated Turnover Scale. The questionnaires were distributed to 60 accessible nurses in CCU. A total of 42 respondents completed the questionnaires with an70 percent response rate. Finding: Nationality and work scheduling were significantly influencing job satisfaction, but marital status and work experience were more influencing the turnover intention. The study finding showed an evidence of considerable highly negative relation between job satisfaction and turnover intention, which was manifested by 78.6% those nurses reporting to be dissatisfied or in neutral responds with their overall job. Moreover, 72.8% of nurses were more likely to hold an intention to leave working place. The most statistically significant predictor of dissatisfaction and lead to leave intention was external reward. Job satisfaction subscale connected to social support was identified as an important factor which may decrease leave intention. Conclusion: The study findings suggested increase nurses' satisfaction through improving benefit package such as health insurance, retirement profits and salary is a key for possible strategy to decrease turnover intention among Coronary Care Unit nurses in Bahrain. Implication for Practice: The study findings have ramifications for nurses' manages to develop strategies aimed at improving the job satisfaction in order to decrease turnover intention.

A comparison of temporary pacing and isoprenaline in treating bradydysrhythmias

Acute bradycardia is a common problem encountered by nurses on the coronary care unit (CCU). This article will aim to compare the different ways of managing this conditon, and consider what role the CCU nurses can play. The article looks at methods of treatment, and compares the pros and cons of each, with a special focus on the role of the CCU nurse in managing the condition. There will also be consideration of the techniques that are beyond the scope of nurses, but which need to be considered as management options.

Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome.

Introduction: Many patients in coronary care unit (CCU) suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS). Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups of 35 subjects. The groups were foot reflexology massage, foot bath, a combination of the two and the control group. Sleep quality was measured using the Veran Snyder-Halpern questionnaire. Data were analyzed by SPSS version 13. Results: The mean age of the four groups was 61.22 (11.67) years. The mean sleep disturbance in intervention groups (foot reflexology massage and foot bath groups) during the second and third nights was significantly less than before intervention. The results also showed a greater reduction in sleep disturbance in the combined group than in the other groups when compared to the control group. Conclusion: It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders and there was a synergistic effect when used in combination. This complementary care method can be recommended to be implemented by CCU nurses.

Mobilization Patterns of Patients After an Acute Myocardial Infarction

This study was aimed to identify the mobilization patterns of acute myocardial infarction (AMI) patients during their first three days in the coronary care unit (CCU) by performing a prospective observational pilot study design. The study included 31 diagnosed AMI patients admitted to three CCUs. Mobilization patterns classified as bed rest, semi-fowler, transfer to chair, and standing/walking were documented by CCU nurses for 72 consecutive hours after patient admission to the CCU. Of 2,232 possible mobilization periods (72 hr × 31 patients), 1,385 recorded observations of mobilization (62%) were obtained. Bed rest and semi-fowler positions were the most common mobilization patterns; together they accounted for 70% of the documented positions over the first 72 hr in the CCU. Patients who experience an uncomplicated AMI spend the majority of their first 72 hr in CCU in bed.

Investigation of nursing workload and related factors of CCU

Objective To investigate nursing workload and related factors of Coronary Care Unit (CCU),and to provide evidence for rationally arranging nursing human resources and improving nursing efficiency.Methods 77 inpatients of a third-grade class-A hospital were surveyed by means of Intensive Care Nursing Scoring System (ICNSS) to investigate workload of CCU nurses.Results Total score of CCU nursing workload was (25.5714 ± 6.48) points.ICNSS scores of the four seasons were (27.24 ± 4.438 ),( 25.62 ±4.535),(22.33 ±9.403),(27.24 ±6.953 ),respectively,the difference was statistically significant (F =11.867,P ＜0.01 ).The LSD multiple comparison showed that there were significant differences of ICNSS scores between the first quarter and the second quarter,the first quarter and the third quarter,the second quarter and the third quarter,the third quarter and the fourth quarter,the difference was statistically significant (P ＜0.05 ).The workload of the nurses who took care of the patients admitted by means of wheel chair and stretcher was (20.74 ± 4.663 ) and (25.89 ± 6.508 ) points,and the difference was statistically significant ( t =0.319,P ＜0.05 ).There was significant difference of nursing workload regarding length of stay and percutaneous coronary intervention (P ＜ 0.05 ).Among same type of disease,workload of CCU nurses was the highest on admission and on the day of percutaneous coronary intervention.Nursing workload was found negatively correlated with length of stay of the patients ( P ＜ 0.05 ).Of the 36 patients undergone percutaneous coronary intervention,the workload of CCU nurses was (26.35 ± 4.057 ) scores on the day of intervention,(23.58 ±3.525) scores on day 1,( 22.16 ± 4.537 ) scores on day 2 and ( 19.17 ± 3.637 ) points after day3,the difference was statistically significant ( F =21.024,P ＜ 0.05 ).Conclusions A flexible staff arrangement should be adopted according to the characters of the disease,patients' conditions and the nursing workload. Key words: Coronary care unit; Nursing workload; Related factors; Human resource management

Correlation between job satisfaction and job stressors of coronary care unit nurses

Objective To study the correlation between job satisfaction and job stressors of coronary care unit (CCU) nurses.Methods A survey was conducted by means of Minnesota Satisfaction Questionnaire (MSQ) and Nurse Job Stressors Scale in 122 CCU nurses.Results The mean score of total job satisfaction of the CCU nurses was (56.42±9.13). In the five aspects of stressors, time allocation and work load (stressor Ⅱ) scored the highest, while work environment and facilities (stressor Ⅲ) scored the lowest. Job satisfaction was negatively correlated with job stressor Ⅰ, Ⅱ, Ⅳ and Ⅴ (P＜0.05). Multiple linear regression analysis showed that internal job satisfaction was influenced by stressor Ⅱ and Ⅰ(t=-8.49,P<0.05;t=-0.26,P<0.05), and external job satisfaction was influenced by stressor Ⅴ and Ⅰ(t=-7.03,P<0.05;t=-3.83,P<0.05).Conclusions The features of job and management in CCU are the major influencing factors of the job satisfaction. Key words: Job satisfaction; Job stressors; Coronary care unit

A model of recovering medical errors in the coronary care unit

The purpose of this study was to explore the thoughts, interpersonal processes, and actions used by nurses who had recently intervened to protect coronary care unit (CCU) patients from potential medical errors. The study used semistructured interviews conducted with 18 very experienced CCU nurses in two academic medical centers. Content analysis was used to code and analyze text segments. Core codes were used for developing an empirically derived model. There were more than 1000 data bits of accounts of involvement in the near-miss events, thought processes and actions surrounding the events, communication strategies used, feelings, outcomes, reflection about the event and consequences, and environment/context in which the events occurred. A three-stage temporally ordered model illustrates the process of recovering medical errors. In stage one, the presence of the evolving clinical scenario and nursing knowledge and expertise plus the CCU context are the antecedents that lead to processes and actions of identification, interruption, and correction of the error in stage two. Outcomes of whether or not the near miss was recovered lead to an adverse event (or not), and reflections on the process and outcome lead to the nurse's feelings about the event in stage three. The model can guide nursing administration, practice, education, and research to recognize and value this responsibility, to teach others, and to test strategies to enhance the vital nursing role of recovering near-miss events that leads to safer and better patient care.

Coronary Care Unit Nurses' Outlook on Death — Their Own Thoughts as Well as Those of Their Patients: A Pilot Study

No studies have examined the level of preparedness of CCU nurses to deal with cardiac patients’ death issues. Accordingly, the aim of this pilot study was to explore and describe CCU nurses’ outlook on their own as well as their patients’ thoughts about death. A pilot study was conducted in 2005 at a University Hospital in southern Sweden. The 63 (93%) nurses answered a newly established 18-item questionnaire regarding their own and their patients’ thoughts about death. Descriptive statistics revealed that 90% of nurses believed that patients often thought about death. Regarding their outlook on death issues, 41% were aware of their personal standpoint, 63% were clear about their plan of action, 34% showed openness towards their patients and 26% expressed educational adequacy. These low figures pertaining to both personal and professional awareness indicate a lack of knowledge and competence. Clinical implications are the provision of various forums at CCUs on this subject and the creation of awareness at all levels of nursing education. Research implications are to further develop the instrument and implement an intervention at the CCU of how to care for dying cardiac patients in a professional manner.

The accessibility of research-based knowledge for nurses in United Kingdom acute care settings.

The successful dissemination of the results of the National Health Service (NHS) research and development strategy and the development of evidence based approaches to health care rely on clinicians having access to the best available evidence; evidence fit for the purpose of reducing the uncertainties associated with clinical decisions. To reveal the accessibility of those sources of information actually used by nurses, as well as those which they say they use. Mixed method case site, using interview, observational, Q sort and documentary audit data in medical, surgical and coronary care units (CCUs) in three acute hospitals. Three perspectives on accessibility were identified: (a) the humanist--in which human sources of information were the most accessible; (b) local information for local needs--in which locally produced resources were seen as the most accessible and (c) moving towards technology--in which information technology begins to be seen as accessible. Nurses' experience in a clinical specialty is positively associated with a perception that human sources such as clinical nurse specialists, link nurses, doctors and experienced clinical colleagues are more accessible than text based sources. Clinical specialization is associated with different approaches to accessing research knowledge. Coronary care unit nurses were more likely to perceive local guidelines, protocols and on-line databases as more accessible than their counterparts in general medical and surgical wards. Only a third of text-based resources available to nurses on the wards had any explicit research base. These, and the remainder were out of date (mean age of textbooks 11 years), and authorship hard to ascertain. A strategy to increase the use of research evidence by nurses should harness the influence of clinical nurse specialists, link nurses and those engaged in practice development. These roles could act as 'conduits' through which research-based messages for practice, and information for clinical decision making, could flow. This role should be explored and enhanced.