Is the care performance of critical care unit nurses in angina management consistent with evidence-based guidelines? An observational study

Demographic and job-related characteristics of nurses_

Variable	Number/average*	Percent/standard deviation**
Age (year)	33.87*	7.14**
Gender
Female	10	14.5
Male	59	85.5
Education
Bachelor’s	60	87.0
Master’s	14	13.0
Employment status
Permanent	44	64.7
Contractual	12	17.6
Conscripted	12	17.6
Shift status
Fixed	14	20.3
Rotational	55	79.9
Education on angina pectoris management
Yes	58	84.1
No	11	15.9

The average score of care performance at different levels of nurses’ demographic and occupational variables_

Variable	Average	Standard deviation	Statistics	The significance level
Gender			t = –0.127	0.899
Female	20.60	7.20
Male	20.82	4.79
Education			Z = –1.686*	0.092
Bachelor’s	21.27	4.64
Master’s or higher	17.63	7.27
Employment status			X2 = 0.230**	0.631
Permanent	20.19	5.40
Contractual	20.58	2.48
Conscripted	22.53	5.72
Shift status			Z = –0.037*	0.970
Fixed	20.02	6.62
Rotational	20.99	4.75
Education about angina management			T = 1.179	0.243
Yes	21.11	5.46
No	19.12	2.57
Age	33.87	7.14	r = –0.265***	0.031

Care performance (and its domains) based on angina management guidelines_

Variable	The range of attainable scores	Mean	Standard deviation	Average out of 100	Standard deviation from 100
Assessment	0–17	12.51	3.31	73.60	19.45
Implementation	0–7	5.02	1.45	71.78	20.67
Reevaluation	0–5	3.18	1.41	63.51	28.27
Total score	0–29	20.71	5.60	71.42	19.31

Sociodemographic details of patients_

Variable	Number/average*	Percent/standard deviation**
Age (year)	55.16*	10.67**
Gender (187)
Male	100	53.5
Female	87	46.5
Marital status (186)
Single	15	8.1
Married	160	86.0
Widow	11	5.9
Educational level (186)
Elementary	32	17.2
Middle School	68	36.6
Diploma	45	24.2
Associate Degree	9	4.8
Bachelor’s Degree and Higher	11	17.2
History of hospitalization (183)
Yes	84	45.9
No	99	54.1

Distribution of the frequency of performing a care function based on EBGs in the management of angina_

Item	Performed
	Frequency	Percent
Checking the intensity of pain	103	50.2
Checking the time of pain onset	188	91.7
Examining the pain site	199	97.1
Assessing the spread of pain to other organs	167	81.5
Checking the duration of pain	143	69.8
Checking pain continuity or interruption	103	50.2
Examining pain aggravating factors	153	74.6
Reviewing pain relief symptoms	169	82.4
Examining pain-related symptoms	183	89.3
Examining pain improvement with position change	131	63.9
Examining pain quality (burning, pressing, sharp, etc.)	118	57.6
Examining cardiac biomarkers such as troponin	191	93.2
Checking the status of the oxygen supply	186	90.7
Checking vital signs	195	95.1
Examining the patient’s ECG in terms of ischemic changes	190	92.7
Auscultating the patient’s lungs (to see if there is shortness of breath)	48	23.4
Examining the patient’s anxiety level (restlessness, frowning, etc.)	98	47.8
Placing the patient in a comfortable position (preferably Fowler’s position)	155	75.6
Absolute rest (CBR) for the patient	202	98.5
NPO until pain control and symptom stabilization	177	86.3
Pain relief as prescribed by the physician	197	96.1
Teaching the patient how to use the nurse call button	48	23.4
Assessing the reduction or resolution of the patient’s pain	168	82.0
Education about angina pectoris and its care to the patient	97	47.3
Education about pain notification to the nurse	154	75.1
Leg pain monitoring every 2 h	145	70.7
Checking the duration of pain every 2 h	82	40.0
Checking the patient’s vital signs every minute until it stabilizes	168	82.0
Examining the patient’s non-verbal reactions	88	42.9