Development of guidelines for the care and referral of patients with acute myocardial infarction (STEMI) in Yangsisurat Hospital Mahasarakham Province
Abstract
Abstract
Acute Coronary Syndrome (ACS) is a critical illness and an emergency due to an acute obstruction of the coronary arteries that requires prompt and accurate care to reduce mortality. This research aims to To develop guidelines for the care and referral of patients with acute myocardial infarction (STEMI) in Yangsisurat Hospital Mahasarakham Province Method of Study are Action Research was conducted from October 2018 to September 2019. Population and sample are purposive sampling including the multidisciplinary team in the hospital, Registered Nurse in Health Promoting Hospital and the patients with acute coronary syndrome. Research tools include the assessment service access form, patient care assessment form,Chest pain assessment form, ACS Registry program (UCHA), In-depth interviews and observational form. Data Analysis by quantitative data are descriptive statistics such as number, percent and qualitative data are triangulation data and content analysis.
Results: Guidelines for care and referral for patients with acute myocardial infarction (STEMI) consisted of 1) assessment of chest pain screening (Rapid screening) from the hospital/admission at ER in Trypical/Atrypical. 2) Enhancing knowledge of nurses in reading/ interpreting initial EKG results and fibrinolytic drugs 3) Supporting adequate equipment and ensuring time for examinations such as EKG, Troponin-T 4) Preparation of guidelines that is consistent with the context, such as CPG in Health Promoting Hospital/hospital, referral criteria 5) Develop a system of consulting Line with the network hospital and the Queen Sirikit Heart Center (Refer by pass). Evaluation found that the multidisciplinary team had increased knowledge and skills. Adequate tools and equipment are available. The patient received prompt laboratory examinations in time. Regarding patient care before and after development, It was found that in 2018 - 2019, 1) onset to needle patients less than 6 hours are 60, 85.71% of 2) STEMI (DTN) patients less than
30 minutes are 60, 85.71% 3) patients diagnosed correctly 100, 100% 4) The incidence of death with AMI 1, 0 respectively. The multidisciplinary team creates care that is suitable for the hospital's potential, enabling treatment to be referred in a timely manner.
Keywords : Care, Referral, STEMI
