Barriers of Nurse Collaboration for the Care of Acute Coronary Syndrome Patients in Emergency Departments: A pilot study

Titin Andri Wihastuti1, Ida Rahmawati2, Septi Dewi Rachmawati1, Yulia Candra Lestari3, Kumboyono Kumboyono1, *
1 School of Nursing, Medical Faculty, Brawijaya University; Malang, East Java, Indonesia
2 School of Nursing, Medical Faculty, Brawijaya University; Malang, East Java, Indonesia
3 School of Nursing, Kendedes Institute of Health Sciences; Malang, East Java, Indonesia



Acute Coronary Syndrome (ACS) is a cardiovascular disease that is one of the main causes of death worldwide. Nurse collaboration in Indonesia is still very complex and inadequate. Positive collaboration in providing care for patients with ACS is essential in the practice of nursing services.


This study aims to explore the barriers in the implementation of nurses-physicians collaboration for the care of patient with ACS in emergency departments (EDs).


This research is a qualitative survey using purposive sampling. It was conducted on 16 nurses who worked in emergency departments from four general hospitals in East Java, Indonesia. Research data were collected using open-ended questions in semi-structured interviews.


There were three themes obtained from the data analysis, which include the difference of confidence between senior and junior nurses in ACS actions, limitations in performing professional nursing, and unclear job responsibilities.


Collaboration of nurses and physicians in emergency departments still faces many problems. It is important to carry out interprofessional education initiations for nursing and medical students, apply peer-mentoring to increase the self-confidence of junior nurse, develop and train the clinical pathway of collaboration between physicians and nurses for the care of ACS patients in EDs.

Keywords: Acute coronary syndrome, Barriers, Collaboration, Emergency nursing, Interprofessional, Physician.

Abstract Information

Identifiers and Pagination:

Year: 2018
Volume: 12
Publisher Item Identifier: EA-TONURSJ-2018-25

Article History:

Received Date: 11/09/2018
Revision Received Date: 22/11/2018
Acceptance Date: 10/12/2018
Electronic publication date: 31/12/2018
Collection year: 2018

© 2018 Wihastuti et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the School of Nursing, Medical Faculty, Universitas Brawijaya, Indonesia; Tel: +6281805004106; Fax: +62 0341 564755; E-mails: /