الفهرس 
Anatomy & physiology of the heartOnly 14 pages are availabe for public view
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Abstract
Acute myocardial infarction (AMI) is a major cause of death and disability worldwide. The ability to recognize the clinical presentation of AMI is critical to achieving timely reperfusion and the reduction of mortality and morbidity associated with misdiagnosed AMIs. Cardiac tissue can best be salvaged within the first 2 hours (120 minutes) after the onset of anginal symptoms, the earlier the myocardium is revascularized, the better are the chances of survival (Basavanthappa, 2015).
The aim of this study to:
Assess factors affecting nurses’ performance for patient with acute myocardial infarction within the golden hours through the following:
1. Assess the nurses’ performance regarding emergency management for patients with acute myocardial infarction within golden hours at critical care unit.
2. Assess the factors that affecting nurses’ performance during emergency management for patients with acute myocardial infarction within golden hours at critical care unit.
Research questions for this study are:
1. What are the nurses’ performance regarding emergency management for acute myocardial infarction patients within golden hours at critical care unit?
2. What are the factors that affecting nurses’ performance during emergency management for patients with acute myocardial infarction within golden hours at critical care unit?
Study design:
A descriptive exploratory design was followed to achieve the aim of this study.
Research setting:
This study was conducted in the emergency department (ED) and CCU units (Cardiac Intensive Care Unit and Emergency Intensive Care Unit) at National Heart Institute Hospital.
Subjects:
A convenient sample of (80 ) registered nurses caring for patients with acute myocardial infarction within golden hours were worked at the previously mentioned setting at the time of data collection and agreed to participate within 7 months (from February 2016 until August 2016) were recruited in this study.
Study tools:
I- Self-administered questionnaire sheet (Appendix I):
It consists of three parts:
Part I: It was concerned with demographic characteristics as age, gender, qualifications, years of experience in Intensive Care Units; attendance of training courses regarding managing acute myocardial infarction patient and the number of training courses had been attended).
Part II: It was used to assess nurses’ opinion about environmental factors affecting their performance, it included communication within work environmental factors (3 items), work environment regulations (7 items), availability of professional support (7 items), job satisfaction (7 items).
Part III: It was used to assess nurses’ knowledge regarding acute myocardial infarction management within golden hours (definition of MI, types of MI, causes, signs and symptoms, deferential diagnosis, ECG procedure, ECG interpretation, complications, medical treatment, thrombolytic therapy, nurse role). It was consisted of (92) MCQ questions.
II- Nurses’ performance observational checklist (Appendix II):
It was used to assess the nurses’ level of practices regarding management of patient with acute myocardial infarction within golden hours it was included: patient assessment, electrocardiographic procedure, thrombolytic medication administration, patient monitoring, peripheral cannula insertion, oxygen therapy administration, defibrillation (cardio version).
III- Nursing staff Attitude regarding emergency management for patients with acute myocardial infarction within golden hours. (Appendix III):
It was used to assess the nurses’ attitude regarding emergency management for patients with acute myocardial infarction within golden hours, consisted of (40) questions, some statements were negative and the others were positive.
Results of this study showed that:
(67.5%) of the studied sample were females and (75%) of them were between (20-30) years old, concerning years of nursing experience, it was found that (70%) of them had nursing experience from one year to <10 yrs, and about (48.8%) had CCU experience less than 10 years. (63%) of them were diploma nurses.Regarding to training courses, about (62.5%) of them had attended training courses about cardiac care, and (45%) attended these programs for only one time.
(52.5%) had unsatisfactory level of knowledge regarding management of acute myocardial infarction within the golden hours, (72.5%) of them had satisfactory level of practice regarding management of AMI within the golden hours, while (28.8%) of the studied nurses had negative attitude regarding management of acute myocardial infarction within the golden hours,
As regard to environmental factors that affect nurses performance in managing patients with acute myocardial infarction within golden hours, the majority (91%) of the studied nurses had active communication within work environment, (44%) of them were dissatisfied with their job, (56.2%) of the studied sample stated that there was no special training courses, and (60%) stated that there was no available skills booklet, also (38.8%, 33.8%) stated that there was no clear protocols, and clear guidelines.
(73.8%) stated that there was unbalanced nurse/ patient ratio, and (55%) stated that job description was not applied, also (50%) of them found that work area was not suitable, while (57.5%) of the studied nurses stated that there was no punishment action in case of unreasonable absenteeism.
There was high statistical significant relation between overall nurses’ knowledge and their gender and significant relation with their age, education and their nursing experience.
There was a high statistical significant relation between overall nurses’ attitude level and their CCU years of experience and training courses of cardiac care.
There was a high statistical significant relation between overall nurses practice level and the number of training courses and significant relation with CCU experience.
There was a statistical significant relation between overall nurses’ knowledge level and availability of technical support.
There was a high statistical significant relation between overall nurses practice level and availability of technical support and work environment regulations.
There was a high statistical significant relation between overall nurses’ attitude level and communication and nurses’ job satisfaction.