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Table 4 Acute myocardial infarction: clinical tasks undertaken by percentage of physicians and nurses, by countries’ SoP, 2015/2016

From: Task shifting between physicians and nurses in acute care hospitals: cross-sectional study in nine countries

  % Physicians performing tasks % Nurses performing tasks (all nurses and APN/SN)
  Countries with SoP expansion [1] Countries with no/limited SoP expansion [2] Countries with SoP expansion [1] Countries with no/limited SoP expansion [2] Countries with SoP expansion [1] Countries with no/limited SoP expansion [2]
AMI % Physicians, N = 30 % Physicians, N = 160 % All nurses, N = 153 % All nurses, N = 348 % APN/SN, N = 68 % APN/SN N = 58
Tasks related to diagnosis/physical examination
 Patient arrival/admission: stabilisation on arrival[ii] 53.3* 34.3* 33.9 31.3 27.9 41.3
 Patient arrival/admission: preparing patient for heart catheterization[ii] 60.0** 31.2** 43.1 45.9 27.9** 53.4**
 Assessment: evaluating which protocol to apply (STEMI)[i] 46.6 40.0 29.4*** 6.3*** 20.5* 6.9*
 Assessment: conducting coronary angiography[i] 60.0*** 22.5*** 3.9 4.0 2.9 3.4
Tasks related to treatment/therapy
 Surgery: performing the catheterisation/ angioplasty[i] 53.3** 14.3** 2.6 3.1 2.9 1.7
 Surgery: conducting percutaneous coronary intervention/angioplasty[i] 40.0** 13.7** 1.9 3.1 2.9 1.7
 Surgery: putting in stent[i] 40.0** 14.3** 1.3 3.1 2.9 1.7
 Surgery: coronary artery bypass graft (CABG)[i] 0.0 3.7 0.6 0.5 1.4 0.0
 Managing complications: resuscitation[ii] 83.3** 57.5** 63.4 70.1 51.4 67.2
 Managing complications: pericarditis[ii] 80.0** 46.8** 39.2 31.6 27.9 32.7
 Managing complications: acute heart failure[ii] 83.3** 55.0** 55.5 50.5 45.5 53.4
 Managing complications: arrhythmias[ii] 86.6** 58.1** 59.4 55.1 45.5 60.3
 Managing complications: ventricular fibrillation[ii] 76.6* 53.7* 56.8 50.5 44.1 55.1
 Managing complications: deep vein thrombosis[ii] 60.0 46.25 33.9 35.9 17.6* 36.2*
 Managing complications: mechanical complications, e.g. septum rupture [i] 70.0*** 29.3*** 13.7 16.6 19.1 22.4
 Care post discharge (hospital-based): Managing co-morbidities/complications: vascular[i] 46.6 43.7 27.4*** 10.0*** 44.1*** 28.5***
 Care post discharge (hospital-based): Managing co-morbidities/complications: respiratory[i] 20.0* 38.7* 15.6* 8.9* 22.0* 6.9*
Tasks related to prescribing medications (AMI)
 Patient arrival/admission: prescribing medication[i,ii] 73.3* 50.6* 10.4 7.7 16.1 6.9
 Patient arrival/admission: administering medication [i] 40.0 21.2 54.9 63.2 35.2** 62.0**
 Prescribing medication according to protocol[i,ii] 70.0 55.6 13.0 12.3 27.9* 10.3*
 Adjusting medication based on initial effects[i,ii] 76.6*** 56.8*** 20.2** 9.7** 33.8** 12.0**
 Administering medication[i] 43.3 29.3 54.9 61.4 41.1 56.9
 Care post discharge (hospital-based): continued prescribing as per discharge letter[i] 26.6 45.6 13.7*** 2.8*** 25.0** 3.4**
 Care post discharge (hospital-based): prescribing medication review[i,ii] 56.6 49.3 31.3*** 5.7*** 52.9*** 5.1***
 Care post discharge (hospital-based): prescribing medication change as necessary[i,ii] 60.0 48.7 25.4*** 2.3*** 44.1*** 3.4***
Tasks related to providing information to patients/coordination and follow-up
 Handover to rehabilitation/primary care: Writing discharge letter to GP/other professional [ii] 73.3** 43.1** 11.7*** 2.3*** 13.2** 0.0**
 Handover: referral to heart rehabilitation[i] 36.6 31.8 50.9*** 4.8*** 36.7*** 5.1***
 Handover: plan for outpatient follow-up[ii] 83.3*** 32.5*** 30.7*** 4.8*** 35.2*** 5.1***
 Follow-up care: lifestyle support[i] 36.6 35.6 41.1*** 15.5*** 61.7*** 17.2***
  1. Source: MUNROS 2015/2016. Rationale for inclusion of tasks: [i] = suggested clinical activities as Advanced Nursing Practice: diagnosis/advanced health assessment, treatment/therapy, prescribing medications, by International Council of Nurses (ICN), [ii] = common medical tasks, reported by the majority of physicians as being part of normal duties (≥ 50% of physicians in ≥ 50% of countries). [1] England, Scotland, Netherlands, [2] Czech Republic, Germany, Italy, Norway, Poland, Turkey
  2. SoP Scope-of-Practice, APN Advanced Practice Nurses, SN Specialist Nurses
  3. ***p value < .001; ** = p value < .01, * = p value < .05