|Individual and institutional factors affecting cardiac monitoring in coronary care units: A national survey of Chinese nurses|
|Zhou, Lin1; Tao, Zhenhui2; Wu, Ying1; Wang, Naqing1; Chen, Tinghui1; Song, Yang1; Deng, Ying1; Zhang, Yarong1|
|关键词||St-segment Monitoring Electrocardiogram Cardiac Monitoring Myocardial Ischemia Coronary Care China|
|刊名||INTERNATIONAL JOURNAL OF NURSING STUDIES|
|收录类别||SCI ; SSCI|
|WOS标题词||Science & Technology|
|关键词[WOS]||MERLIN-TIMI 36 ; MYOCARDIAL-INFARCTION ; ELECTROCARDIOGRAPHY ; ISCHEMIA ; STANDARD ; ECG|
Background: As cardiovascular diseases have become the leading cause of death in many countries including China, nurses are increasingly required to be abreast of technological advances and the skills necessary to manage this increasing health care problem. Chinese nurses are under pressure to provide skilled electrocardiography monitoring, and be sufficiently skilled to detect myocardial ischemia and infarction, in this large patient population. This presents a challenge for the nursing profession in China, particularly for nurses working in coronary care in a country where advancement has been so rapid, yet little research has been conducted or reported in the literature.
Objectives: The two main objectives were: to explore the demographic and educational factors that affect the use of ST-segment monitoring and correct electrode placement by CCU/ICU nurses in China; and to explore the factors both individual and institutional that affect monitoring and lead placement.
Methods: A self-administered questionnaire was distributed to nurses in 126 randomly selected tertiary hospitals, which were stratified into three homogeneous regions across China. The instrument examined demographics, information about hospitals, electrocardiogram devices, current practice patterns and perceptions toward monitoring and lead placement. Data from 734 nurses and 59 nurse managers from 59 hospitals were analyzed using t-tests, ANOVA, Chi-square test and logistic regression.
Results: Electrocardiogram monitoring was used to detect myocardial ischemia by 43.7% of respondents, and 35.1% selected leads according to electrocardiogram or angiography findings. Most (70%) agreed that monitoring for acute coronary syndrome was important, while 39.2% did so, and 15.7% were able to identify correct placement. Logistic regression revealed a significant relationship between the uses of ST-segment monitoring and number of hospital beds, continuing education and a belief in its use and ease of use. Correct electrode placement was significantly correlated with respondents from university hospitals, hospitals with more acute coronary syndrome admissions and more independent thinking nurses.
Conclusions: Despite best practice evidence, less than half of the sample used electrocardiogram monitoring to detect myocardial ischemia and the majority could not identify correct electrode placement, while ST-segment monitoring was not used routinely. This paper highlights the need for improvements in education both in universities and hospitals and discussion addresses conventions in units, which inhibit development of nurses′ skills. (C) 2011 Elsevier Ltd. All rights reserved.
|资助机构||Capital Medical University ; Joint Research Foundation of Basic and Clinical Medical Science Research of Capital Medical University|
|作者单位||1.Capital Med Univ, Sch Nursing, Beijing 100069, Peoples R China|
2.Peking Univ, Capital Med Univ, Sch Nursing, Hemodialysis Unit,Hosp 1, Beijing 100871, Peoples R China
|Zhou, Lin,Tao, Zhenhui,Wu, Ying,et al. Individual and institutional factors affecting cardiac monitoring in coronary care units: A national survey of Chinese nurses[J]. INTERNATIONAL JOURNAL OF NURSING STUDIES,2012,49(5):570-578.|
|APA||Zhou, Lin.,Tao, Zhenhui.,Wu, Ying.,Wang, Naqing.,Chen, Tinghui.,...&Zhang, Yarong.(2012).Individual and institutional factors affecting cardiac monitoring in coronary care units: A national survey of Chinese nurses.INTERNATIONAL JOURNAL OF NURSING STUDIES,49(5),570-578.|
|MLA||Zhou, Lin,et al."Individual and institutional factors affecting cardiac monitoring in coronary care units: A national survey of Chinese nurses".INTERNATIONAL JOURNAL OF NURSING STUDIES 49.5(2012):570-578.|