The triage Nurse's ability in electrocardiogram interpretation in real clinical practice

Area of Science:

• Cardiology
• Nursing Practice
• Emergency Medicine

Background:

• Limited data exists on nurses' electrocardiogram (ECG) interpretation skills in real clinical settings.
• Previous studies conducted in simulation settings yielded conflicting results.

Purpose of the Study:

• To evaluate the accuracy of triage nurses in identifying abnormal electrocardiograms during patient assessment.
• To determine factors related to nurses and patients that are associated with electrocardiogram interpretation errors.

Main Methods:

• A prospective, single-center observational study involving 20 triage nurses and 644 patients with cardiovascular symptoms.
• Nurses determined if the 12-lead electrocardiogram was pathological or non-pathological.
• Inter-rater agreement with physicians was the primary outcome; major acute cardiovascular events were secondary.

Main Results:

• A modest concordance (Cohen's Kappa = 0.666) was observed between nurses and physicians in electrocardiogram interpretation.
• 11% of electrocardiogram interpretations by nurses contained errors.
• Recent ECG training and autonomous study by nurses correlated with fewer errors, while older patients and those with prior cardiovascular disease were associated with more errors.

Conclusions:

• Triage nurses possess a fair ability to interpret electrocardiograms in clinical practice.
• Targeted educational programs focusing on electrocardiogram interpretation can enhance nurses' skills, making ECGs a vital triage tool.