Emergency Nursing

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https://hdl.handle.net/20.500.11888/20336

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    SIGNIFICANCE OF HEART SCORE IN CHEST PAIN PATIENT AT EMERGENCY DEPARTMENT
    (An-Najah National University, 2025-06-19) Abu Amer, Salam
    Background: Chest pain is one of the most common symptoms of patients presenting to the Emergency Department (ED), and the diagnosis of chest pain poses significant challenges. This study evaluates the effectiveness of the HEART score in risk stratification of these patients according to the susceptibility of Acute Coronary Syndrome (ACS), compared to traditional clinical diagnosis, at an Emergency Department of Northwest Bank Central Hospital. Methods: A retrospective cohort study was conducted in a central North West Bank hospital, involving 247 patients were complaining of chest pain as a presenting symptom, to assess the susceptibility of ACS. Patients were randomly assigned to either the HEART score group (n=124) or the control group (n=123). The primary outcome was the occurrence of Major Adverse Cardiac Events (MACE) within 6 weeks. Results: The HEART score group demonstrated a significantly lower occurrence of MACE in comparison to the control group (2.4% vs 8.1%, p=0.044). The HEART score effectively stratified patients into low (54.8%), intermediate (22.6%), and high (22.6%) risk categories, guiding the selection of appropriate interventions. While the admission rates were higher in the HEART group, suggesting more precise risk-based hospitalization, and similar time for length of stay at the ED. Conclusion: Introducing the use of the HEART score in classifying Emergency Department (ED) chest pain presenting patients will significantly reduce the occurrence of MACE (2.4% HEART group vs. 8.1% traditional clinical diagnosis, p=0.044), validating its use as a safer, more efficient risk-stratification tool. The implementation of the HEART score can regulate the care provided for chest pain patients in resource-limited settings. improving patient outcomes and potentially optimizing resource utilization.
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    ASSESSMENT OF PATIENTS’ EXPERIENCE IN THE EMERGENCY DEPARTMENTS IN WEST BANK – PALESTINE: A QUANTITATIVE CROSS-SECTIONAL STUDY
    (An-Najah National University, 2024-10-23) Abdallah, Sojoud Bashar
    Introduction: The experience of patients in healthcare institutions is a complex and multifactorial, and is related to sociodemographic, cultural, and institutional factors, and their perceptions of healthcare services. This is more obvious in critical and overcrowded settings like emergency departments (EDs), in which the following study aimed to assess patients’ experience in selected Palestinian hospitals, as well as the main demographic and patient-related factors affecting the general experience level. Method: The study implemented a cross-sectional, quantitative design on a convenient sample of 405 adult patients who visited EDs in the targeted hospitals, and were asked to fill in a valid questionnaire called the Accident and Emergency Department Questionnaire (A&ED) that was translated and back-translated to Arabic language, and validated by 5 experts. Data were treated in anonymity and confidentiality and were analyzed using SPSS software. Results: The median age of patients was 28 years old (IQR = 2), with 57.8% females, 24.2% visited the ED for respiratory system indication, 27.2% care for others, and 72.8% of the questionnaires were filled in by the patient. More than half of the patients reported being treated in dignity and respect all of the time (56.0%), which was reflected by positive opinions related to waiting, communication, environment, and other domains, resulting in a satisfactory median score of overall experience (7 out of 10), which was significantly higher with age (r = 0.114, p-value = 0.022), female patients (p-value = 0.010), who did not suffer from health conditions for the last 12 months (p-value = 0.012), who do not care for others (p-value = 0.038) and when the questionnaire was filled in by the patient himself/herself (p-value < 0.001). Conclusion: The overall experience of Palestinian patients in EDs is moderate, and affected by several factors, which should be considered in continuous and evidence-based programs that enhance environmental and institutional factors and target the improvement of HCPs skills and emergency dynamics. Further longitudinal research is needed that covers more related factors. Keywords: patient, experience, perception, emergency department, emergency room