Nursing criteria for patient progression post myocardial infarction

Nurses play a pivotal role in the evaluation of patients with coronary artery disease, since many symptoms are subtle and arise while carrying out activities. Consistency among nursing staff in interpreting patient readiness for activity is crucial to ensure that patients are progressing steadily or to determine if a delay in their progression is warranted. While there have been studies on patient reaction to myocardial infarction and on the physiological effects of activity and/or nursing interventions on myocardial patients, no studies could be found that have examined the criteria used by nurses to assess when patients are ready to increase, decrease or maintain a level of activity according to specific activity protocols. This descriptive study examined the criteria utilized by experienced staff nurses in determining post myocardial patients' readiness to progress through the institution's designated activity levels. The results indicated that in-depth criteria were utilized by these experienced nurses and that patient situations existed whereby it was difficult to determine patient readiness. Factors were discovered that were perceived to enhance or inhibit patient's progression through designated activity levels. Recommendations from this study support the need to (a) examine the use of current activity protocols for their utility in nursing decision making, (b) consider the experiential base of practicing nurses as well as the working environment in any further development of activity protocols.