Gender and age differences in nurses' triage decisions using vignette patients

Area of Science:

• Emergency Medicine
• Cardiology
• Nursing Practice

Background:

• Women experiencing myocardial infarction (MI) often receive delayed diagnosis and less aggressive treatment compared to men.
• Existing research primarily focuses on physician bias in MI triage, with limited data on nursing decision-making.

Purpose of the Study:

• To investigate if emergency department (ED) nurses' triage decisions differ based on patient gender when presented with identical myocardial infarction (MI) symptoms.
• To explore potential gender and age biases in nursing triage for acute cardiac events.

Main Methods:

• A descriptive study involving 500 randomly selected ED nurses.
• Nurses received mailed clinical vignette questionnaires presenting standardized MI symptoms in different patient demographics.
• Data were analyzed using descriptive, bivariate, and multivariate statistical methods.

Main Results:

• ED nurses were more likely to triage middle-aged male patients for urgent care and intensive care unit (ICU) admission compared to equally symptomatic middle-aged females.
• Nurses were significantly more likely to consider a cardiac diagnosis for males than females with identical presentations.
• No significant gender-based differences in triage decisions were observed for elderly patients.

Conclusions:

• Findings suggest that gender bias and ageism may influence ED nurses' triage decisions for middle-aged women with suspected coronary artery disease.
• Disparities in triage may contribute to poorer outcomes for women with MI.
• Despite potentially lower MI incidence, increased morbidity and mortality in middle-aged women necessitate consideration in triage protocols.