Cent Eur J Nurs Midw 2022, 13(4):741-753 | DOI: 10.15452/cejnm.2022.13.0007

Graduating nursing students’ competence in nursing patients with acute coronary syndrome

Riitta Turjamaa1, Johanna Simon-Bellamy2,3, Leena Salminen2,4, Eliisa Löyttyniemi5, Satu Kajander-Unkuri2,6
1 Unit of Continuous Learning, Savonia University of Applied Sciences, Kuopio, Finland
2 Department of Nursing Science, Faculty of Medicine, University of Turku, Finland
3 Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland
4 Turku University Hospital, Finland
5 Department of Biostatistics, University of Turku, Turku, Finland
6 Unit of Pedagogy and Research, Diaconia University of Applied Sciences, Helsinki, Finland

Aim:  To describe graduating nursing students’ competence based on their knowledge in the nursing of a patient with acute coronary syndrome (ACS) and their self-assessed nurse competence. Design: A cross-sectional survey. Methods: The data were collected from 2018–2019 using an ACS test developed for this study and using the Nurse Competence Scale. The sample contained 47 graduating nursing students. The statistical analysis methods were used. Results: Only 48.9% (n = 23) of the students scored an accepted level of knowledge in the nursing of a patient with ACS, and a little over half (51.1%; n = 24) failed the ACS test. Graduating nursing students’ self-assessed nurse competence was at a good level (69.7; VAS 0–100). No statistically significant differences in nurse competence assessments occurred between students who passed the ACS test and those who failed it. Conclusion: While graduating nursing students have a good level of nursing competence, their knowledge in the nursing of a patient with ACS was poor. It is important to emphasize the nursing of a patient with ACS in nursing education and to pay especially close attention to interpreting the patient’s electrocardiogram findings.

Keywords: acute coronary syndrome, competence, graduating nursing student, knowledge-test, Nurse Competence Scale

Received: January 10, 2022; Revised: March 23, 2022; Accepted: March 24, 2022; Published: December 5, 2022  Show citation

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Turjamaa R, Simon-Bellamy J, Salminen L, Löyttyniemi E, Kajander-Unkuri S. Graduating nursing students’ competence in nursing patients with acute coronary syndrome. Central European Journal of Nursing and Midwifery. 2022;13(4):741-753. doi: 10.15452/cejnm.2022.13.0007.
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    References

    1. Aiken, L. H., Sloane, D., Griffiths, P., Rafferty, A. M., Bruyneel, L., McHugh, M., Maier, C. B., Moreno-Casbas, T., Ball, J. E., Ausserhofer, D., Sermeus, W., & RN4CAST Consortium. (2017). Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality & Safety, 26(7), 559-568. https://doi.org/10.1136/bmjqs-2016-005567. Go to original source... Go to PubMed...
    2. Arslanian-Engoren, C., Hagerty, B., Antonakos, C. L., & Eagle, K. A. (2010). The feasibility andutility of the aid to cardiac triage intervention to improve nurses' cardiac triage decisions. Heart & Lung, 39(3), 201-207. https://doi.org/10.1016/j.hrtlng.2009.08.004 Go to original source... Go to PubMed...
    3. Ballard, N., Bairan, A., Newberry, L., Van Brackle, L., & Barnett, G. (2011). Effect of education on a chest pain mnemonic on door-to-ECG time. Journal of Emergency Nursing, 37(3), 220-224. https://doi.org/10.1016/j.jen.2010.02.018 Go to original source... Go to PubMed...
    4. Cardona-Morrell, M., Prgomet, M., Lake, R., Nicholson, M., Harrison, R., Long, J., Westbrook, J., Braithwaite, J., & Hillman, K. (2016). Vital signs monitoring and nurse-patient interaction: a qualitative observational study of hospital practice. International Journal of Nursing Studies, 56, 9-16. https://doi.org/10.1016/j.ijnurstu.2015.12.007 Go to original source... Go to PubMed...
    5. Carlton, E. W., Khattab, A., & Greaves, K. (2016). Beyond triage: the diagnostic accuracy of emergency department nursing staff risk assessment in patients with suspected acute coronary syndromes. Emergency Medicine Journal, 33(2), 99-104. https://doi.org/10.1136/emermed-2015-204780. Go to original source... Go to PubMed...
    6. Chow, S. K. Y., Chan, Y. Y., Ho, S. K., & Ng, K. C. (2017). Cardiac health knowledge and misconceptions among nursing students: implications for nursing curriculum design. BMC Nursing, 16, 46. https://doi.org/10.1186/s12912-017-0241-3. Go to original source... Go to PubMed...
    7. Current Care Guideline. (2014, June 3). Sepelvaltimotautikohtaus [Acute coronary syndrome: unstable angina and myocardialinfarction without ST elevation]. Retrieved January 9, 2022, from https://www.kaypahoito.fi/kht00144
    8. Davis, L. L., & Maness, J. J. (2019). Nurse practitioner knowledge of symptoms of acute coronary syndrome. The Journal for Nurse Practitioners, 15(1), e9-e12. https://doi.org/10.1016/j.nurpra.2018.09.017 Go to original source... Go to PubMed...
    9. Diaconia University of Applied Sciences. (2022). Curriculum Nursing Degree. Diak. https://opinto-opas.diak.fi/en/43204/en/47046/2020NURSING/314/year/2022
    10. European Commission. (2005). Directive 2005/36/EC. https://eur-lex.europa.eu/legal-content/FI/ALL/?uri=celex:32005L0036
    11. European Commission. (2013). Directive 2013/55/EU. EC. https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32013L0055&from=EN.
    12. European Commission. (2020). Causes of death statistics. EC. Eurostat. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Causes_of_death_statistics
    13. European Medicines Agency. (2021). Medication errors. https://www.ema.europa.eu/en/human-regulatory/post-authorisation/pharmacovigilance/medication-errors
    14. European Society of Cardiology. (2021). Understanding the burden of CVD. Facts and figures. ESC. https://www.escardio.org/The-ESC/Advocacy/understanding-the-burden-of-cvd-facts-and-figures.
    15. Flinkman, M., Leino-Kilpi, H., Numminen, O., Jeon, Y., Kuokkanen L., & Meretoja, R. (2017). Nurse competence scale: a systematic and psychometric review. Journal of Advanced Nursing, 73(5), 1035-1050. https://doi.org/10.1111/jan.13183. Go to original source... Go to PubMed...
    16. Freysdķttir, G. R., Björnsdķttir, K., & Svavarsdķttir, M. H. (2019). Nurses' use of monitors in patient surveillance: an ethnographic study on a coronary care unit. European Journal of Cardiovascular Nursing, 18(4), 272-279. https://doi.org/10.1177/1474515118816930 Go to original source... Go to PubMed...
    17. Funk, M., Fennie, K. P., Stephens, K. E., May, J. L., Winkler, C. G., Drew, B. J., & PULSE Site Investigators. (2017). Association of implementation of practice standards for electrocardiographic monitoring with nurses' knowledge, quality of care, and patient outcomes: findings from the Practical Use of the Latest Standards of Electrocardiography (PULSE) Trial. Circulation. Cardiovascular Quality and Outcomes, 10(2), e003132. https://doi.org/10.1161/CIRCOUTCOMES.116.003132 Go to original source... Go to PubMed...
    18. Havola, S., Koivisto, J.-M., Mäkinen, H., & Haavisto, E. (2020). Game elements and instruments for assessing nursing students' experiences in learning clinical reasoning by using simulation games: an integrative review. Clinical Simulation in Nursing, 46, 1-14. https://doi-org.ezproxy.utu.fi/10.1016/j.ecns.2020.04.003 Go to original source...
    19. Holmberg, M., Fagerberg, I., & Wahlberg, A. C. (2017). The knowledge desired by emergency medical service managers of their ambulance clinicians: a modified Delphi study. International Emergency Nursing, 34, 23-28. https://doi.org/10.1016/j.ienj.2017.03.007 Go to original source... Go to PubMed...
    20. Hsu, L. L., Huang, Y. H., & Hsieh, S. I. (2014). The effects of scenario-based communication training on nurses' communication competence and self-efficacy and myocardial infarction knowledge. Patient Education and Counseling, 95(3), 356-364. https://doi.org/10.1016/j.pec.2014.03.010 Go to original source... Go to PubMed...
    21. Jakobsson, S., Huber, D., Björklund, F., & Mooe, T. (2016). Implementation of a new guideline in cardiovascular secondary preventive care: subanalysis of a randomized controlled trial. BMC Cardiovascular Disorders, 16, 77. https://doi.org/10.1186/s12872-016-0252-0 Go to original source... Go to PubMed...
    22. Kajander-Unkuri, S., Meretoja, R., Katajisto, J., Saarikoski, M., Salminen, L., Suhonen, R., & Leino-Kilpi, H. (2014). Self-assessed level of competence of graduating nursing students and factors related to it. Nurse Education Today, 34(5), 795-801. https://doi.org/10.1016/j.nedt.2013.08.009 Go to original source... Go to PubMed...
    23. Kajander-Unkuri, S., Leino-Kilpi, H., Katajisto, J., Meretoja, R., Räisänen, A., Saarikoski, M., Salminen, L., & Suhonen, R. (2016). Congruence between graduating nursing students' self-assessment and mentors' assessments of students' nurse competence. Collegian, 23(3), 303-312. https://doi.org/10.1016/j.colegn.2015.06.002 Go to original source...
    24. Kajander-Unkuri, S., Melender, H-L., Kanerva, A-M., Korhonen, T., Suikkanen, A., & Silén-Lipponen M. (2020a). Sairaanhoitajien osaamisvaatimukset - suomalainen koulutus 2020-luvulle. Appendix 3, Competence requirements and their contents [Competence requirements for nurses - Finnish education for the 2020s]. In: Silén-Lipponen & Korhonen (Ed.). Osaamisen ja arvioinnin yhtenäistäminen sairaanhoitajakoulutuksessa -yleSHarviointi-hanke [Unification of competence and assessment in nursing education - general assessment project] (pp. 117-128). https://www.theseus.fi/bitstream/handle/10024/347289/2020-5yleshArviointi.pdf?sequence=1&isAllowed=y
    25. Kajander-Unkuri, S., Meretoja, R., Katajisto, J., Leino-Kilpi, H., & Suikkala, A. (2020b). Students' self-assessed competence levels during nursing education continuum: a cross-sectional survey. International Journal of Nursing Education Scholarship, 17(1). https://doi.org/10.1515/ijnes-2019-0050. Go to original source... Go to PubMed...
    26. Kajander-Unkuri, S., Koskinen, S., Brugnolli, A., Cerezuela Torre, M., Elonen, I., Kielė, V., Lehwaldt, D., Löyttyniemi, E., Nemcová, J., Simão de Oliveira, C., Palese, A., Rua, M., Salminen, L., Šateková, L., Stubner, J., Sveinsdķttir, H., Visiers Jiménez, L., & Leino-Kilpi, H. (2021). The level of competence of graduating nursing students in 10 European countries: comparison between countries. Nursing Open, 8(3), 1048-1062. https://doi.org/10.1002/nop2.712. Go to original source... Go to PubMed...
    27. Kiekkas, P., Michalopoulos, E., Igoumenidis, M., Michalopoulos, A., & Stefanopoulos, N. (2019). Factors associated with self-reported competence of graduating nursing students. Collegian, 26(2), 267-272. https://doi.org/10.1016/j.colegn.2018.08.004 Go to original source...
    28. Kvande, M., Delmar, C., Lykkeslet, E., & Storli, S. L. (2017). Assessing changes in a patient's condition - perspectives of intensive care nurses. Nursing in Critical Care, 22(2), 99-104. https://doi.org/10.1111/nicc.12258 Go to original source... Go to PubMed...
    29. Lakanmaa, R. L., Suominen, T., Perttilä, J., Ritmala-Castrèn, M., Vahlberg, T., & Leino-Kilpi, H. (2014). Graduating nursing students' basic competence in intensive and critical care nursing. Journal of Clinical Nursing, 23(5-6), 645-653. https://doi.org/10.1111/jocn.12244 Go to original source... Go to PubMed...
    30. Lee, J., Kim, E., Kim, S., & Oh, E.G. (2020). A systematic review of early warning systems' effects on nurses' clinical performance and adverse events among deteriorating ward patients. Journal of Patient Safety, 16(3), e104-e113. https://doi.org/10.1097/PTS.0000000000000492. Go to original source... Go to PubMed...
    31. Lejonqvist, G-B., & Kajander-Unkuri, S. (2022). Evaluating nursing competence with the Nurse Competence Scale from ontological and contextual point of view: an integrative literature review. Nordic Journal of Nursing Research, 42(1), 7-17.https://doi.org/10.1177/20571585211000972 Go to original source...
    32. Meretoja, R., Isoaho, H., & Leino-Kilpi, H. (2004a). Nurse Competence Scale: development and psychometric testing. Journal of Advanced Nursing, 47(2), 124-133. https://doi.org/10.1111/j.1365-2648.2004.03071.x Go to original source... Go to PubMed...
    33. Meretoja, R., Leino-Kilpi, H., & Kaira, A. M. (2004b). Comparison of nurse competence in different hospital work environments. Journal of Nursing Management, 12(5), 329-336. https://doi.org/10.1111/j.1365-2834.2004.00422.x Go to original source... Go to PubMed...
    34. Metropolia University of Applied Sciences. (2022). Curriculum degree programme in Nursing. Metropolia. https://opinto-opas.metropolia.fi/en/88094/en/70308/SXN22S1/year/2022
    35. Nikula, A. (2011). Vaccination competence: the concept and evaluation. (Publication No. D995) [Doctoral dissertation, University of Turku]. UTUPub. https://urn.fi/URN:ISBN:978-951-29-4829-1
    36. Nilsson, J., Mischo-Kelling, M., Thiekoetter, A., Deufert, D., Mendes, A. C., Fernandes, A., Kirchhoff, J. W., & Lepp, M. (2019). Nurse professional competence (NPC) assessed among newly graduated nurses in higher educational institutions in Europe. Nordic Journal of Nursing Research, 39(3), 159-167. https://doi.org/10.1177/2057158519845321. Go to original source...
    37. Norton, C. (2017). Acute coronary syndrome: assessment and management. Nursing Standard, 31(29), 61-70. https://doi.org/10.7748/ns.2017.e10754. Go to original source... Go to PubMed...
    38. Notarnicola, I., Stievano, A., Pulimeno, A., Iacorossi, L., Petrizzo, A., Gambalunga, F., Rocco, G., Petrucci, C., & Lancia, L. (2018). Evaluation of the perception of clinical competencies by nursing students in the different clinical settings: an observational study. Annali di Igiene: Medicina Preventiva E di Comunità, 30(3), 200-210. https://doi.org/10.7416/ai.2018.2211. Go to original source... Go to PubMed...
    39. Official Statistics of Finland. (2019). Causes of death. Statistics Finland. http://www.stat.fi/til/ksyyt/2019/ksyyt_2019_2020-12-14_kat_002_en.html
    40. Olgers, T. J., Dijkstra, R. S., Drost-de Klerck, A. M., & Ter Maaten, J. C. (2017). The ABCDE primary assessment in the emergency department in medically ill patients: an observational pilot study. The Netherlands Journal of Medicine, 75(3), 106-111.
    41. Ragsdale, M., & Schuessler, J. B. (2021). The impact of simulation and senior practicum on graduating senior nursing students' readiness for practice. Clinical Simulation in Nursing, 53, 66-70. https://doi.org/10.1016/j.ecns.2020.10.001 Go to original source...
    42. Roche, T. E., Gardner, G., & Jack, L. (2017). The effectiveness of emergency nurse practitioner service in the management of patients presenting to rural hospitals with chest pain: a multisite prospective longitudinal nested cohort study. BMC Health Services Research, 17(1), 445. https://doi.org/10.1186/s12913-017-2395-9 Go to original source... Go to PubMed...
    43. The Royal College of Physicians. (2017). National Early Warning Score (NEWS) 2: standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
    44. Ryder, S., Fox, K., Rane, P., Armstrong, N., Wei, C. Y., Deshpande, S., Stirk, L., Qian, Y., & Kleijnen, J. (2019). A systematic review of direct cardiovascular event costs: an international perspective. PharmacoEconomics, 37(7), 895-919. https://doi.org/10.1007/s40273-019-00795-4 Go to original source... Go to PubMed...
    45. Savonia University of Applied Sciences. (2022). Curriculum Bachelor's degree programme in Nursing. Savonia. https://www.savonia.fi/opiskele-tutkinto/tutkinnot-ja-hakeminen/opetussuunnitelmat/?yks=KS&krtid=1534
    46. Shatto, B., Shagavah, A., Krieger, M., Lutz, L., Duncan, C. E., & Wagner, E. K. (2019). Active learning outcomes on NCLEX-RN or standardized predictor examinations: an integrative review. Journal of Nursing Education, 58(1), 42-46. https://doi.org/10.3928/01484834-20190103-07. Go to original source... Go to PubMed...
    47. Smith, J. N., Negrelli, J. M., Manek, M. B., Hawes, E. M., & Viera, A. J. (2015). Diagnosis and management of acute coronary syndrome: an evidence-based update. Journal of the American Board of Family Medicine, 28(2), 283-293. https://doi.org/10.3122/jabfm.2015.02.140189 Go to original source... Go to PubMed...
    48. Tahboub, O. Y. H., & Yilmaz, Ü. D. (2019). Nurses' knowledge and practices of electrocardiogram interpretation. International Cardiovascular Research Journal, 13(3), 80-84.
    49. Taylor, I., Bing-Jonsson, P., Wangensteen, S., Finnbakk, E., Sandvik, L., McCormack, B., & Fagerström, L. (2019). The self-assessment of clinical competence and the need for further training: a cross-sectional survey of advanced practice nursing students. Journal of Clinical Nursing, 29(3-4), 545-555. https://doi.org/10.1111/jocn.15095 Go to original source... Go to PubMed...
    50. Vartiainen, E. (2018). The North Karelia Project: cardiovascular disease prevention in Finland. Global Cardiology Science & Practice, 2018(2), 13. https://doi.org/10.21542/gcsp.2018.13 Go to original source... Go to PubMed...
    51. Vipunen - Education Statistics Finland. (2021). Attained degrees in UAS education. https://vipunen.fi/en-gb/_layouts/15/xlviewer.aspx?id=/en-gb/Reports/Ammattikorkeakoulujen%20tutkinnot%20-%20vuosi_EN.xlsb
    52. Visiers-Jiménez, L., Suikkala, A., Salminen, L., Leino-Kilpi, H., Löyttyniemi, E., Henriques, M., Jiménez Herrera, M. F., Nemcova, J., Pedrotti, D., Rua, M., Tommasini, C., Zeleníková, R., & Kajander-Unkuri, S. (2021). Clinical learning environment and graduating nursing students' competence: a multi-country cross-sectional study. Nursing and Health Sciences, 23(2), 398-410. https://doi.org/10.1111/nhs.12819 Go to original source... Go to PubMed...
    53. Visiers-Jiménez, L., Palese, A., Brugnolli, A., Cadorin, L., Salminen, L., Leino-Kilpi, H., Löyttyniemi, E., Nemcova, J., Simão de Oliveira, C., Rua, M., Zelenikova, R., & Kajander-Unkuri, S. (2022). Nursing students' self-directed learning abilities and related factors at graduation: a multi-country cross-sectional study. Nursing Open, 9(3), 1688-1699. https://doi.org/10.1002/nop2.1193. Go to original source... Go to PubMed...
    54. von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & STROBE Initiative. (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ, 335(7624), 806-808. https://doi.org/10.1136/bmj.39335.541782.AD Go to original source... Go to PubMed...
    55. Walton, B. G. (2016). Developing a nursing IQ - Part II: the expertise of nursing process. Ohio Nurses Review, 91(5), 24-34.
    56. Weeks, J., Johnson, J., & Jones, E. (2017). Are triage nurse knowledgeable about acute coronary syndromes recognition? ABNF Journal, 28(3), 69-75.
    57. World Health Organization. (2020). State of the world's nursing 2020: investing in education, jobs and leadership. WHO. https://apps.who.int/iris/bitstream/handle/10665/331677/9789240003279-eng.pdf?sequence=1&isAllowed=
    58. World Health Organization. (2021). Cardiovascular diseases (CVDs). WHO. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

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