Background: Cardiovascular emergencies, including myocardial infarction, cardiac arrest, and acute coronary syndromes, require rapid, coordinated interventions. Nurses play a critical role in initial assessment, stabilization, and ongoing care. However, inconsistent integration of nursing practices into emergency protocols often leads to delayed interventions and suboptimal patient outcomes. Therefore, this study aims to fill these gaps by evaluating nursing integration in acute cardiovascular emergency protocols using mixed-methods approaches.

Methods: A mixed-methods study was conducted in three tertiary care hospitals over six months. Quantitative data were collected from a consecutive sample of 150 cardiovascular emergency cases, comparing outcomes between standard protocols and those revised to include structured nursing interventions. The sample size of 150 was determined by power calculation (α = 0.05, power = 0.80, effect size = 0.5). Qualitative data were obtained through purposive sampling of 25 emergency nurses, focusing on perceived barriers and facilitators to protocol implementation. Quantitative data were analyzed using SPSS (version 26) with chi-square and t-tests, while qualitative interviews underwent thematic analysis. The study included 75 participants in the control group and 75 in the intervention group.

Results: Patients managed under integrated nursing protocols had significantly shorter response times (mean reduction of 4.5 minutes to the first intervention; P < 0.01), increased adherence to treatment guidelines, and a 15% reduction in 30-day readmissions. Nurses reported enhanced confidence, role clarity, and team communication. Key best practices identified included nurse-led triage algorithms, rapid cardiac assessment tools, and structured communication during handovers.

Conclusion: Integrating nursing care into cardiovascular emergency protocols significantly improves patient outcomes, including reduced intervention times and readmissions. Enhanced nurse clarity and teamwork were noted, alongside barriers to implementation. Key implications include developing policies for structured roles, providing ongoing training, fostering collaboration, and continuously monitoring protocol effectiveness.

Keywords: Best Practices, Cardiovascular, Emergency Nursing, Protocol Integration

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