The advanced practice nurse's role regarding women's delay in seeking treatment with myocardial infarction

To synthesize nursing literature on reasons women delay in seeking treatment for signs and symptoms of an acute myocardial infarction (AMI), to hypothesize upon the primary reason(s) for this delay, and to propose advanced practice nurse (APN) interventions to reduce this delay.

Utilizing Stetler's Model of Research Utilization, all reports published in nursing journals within the last 10 years specifically examining prehospital delay related to gender factors were analyzed.

Women, especially those in advanced age, delay longer before seeking treatment for signs and symptoms of AMI. Effective treatment is time dependent; mortality and morbidity rise with increased prehospital delay. The reasons identified in the literature for this delay included severity, specificity, atypical presentation of symptoms, differences in event perception according to gender roles, and the interpretation and attribution of symptoms.

Identifying and teaching women at highest risk for delay, dispelling internal and external gender bias, increasing one's perception of patient vulnerability to AMI, and developing one's awareness of atypical presentations are the major factors that are likely to impact APN practice and consequently reduce prehospital delays for women at risk.