The Development of care and referral models for patients with acute myocardial infarction (STEMI) at Wapi Pathum Hospital Maha Sarakham Province

Abstract

Abstract

            This action research aimed to develop a model and evaluate the outcomes of care and referral for patients with acute myocardial infarction (STEMI) at Wapipathum Hospital, Maha Sarakham Province. The study was conducted between April 2023 and September, 2024, and consisted of four phases: Phase 1 involved studying and analyzing the problem situation and planning; Phase 2 focused on developing a care and referral model for STEMI patients; Phase 3 implemented the model; and Phase 4 evaluated the model's development and outcomes. The sample consisted of 103 STEMI patients, selected through purposive sampling. Research instruments included: (1) a data recording form for medical records and STEMI patient information, (2) a clinical outcome recording form, and (3) a satisfaction assessment form. Data were analyzed using percentages, means, standard deviation, and
t-test.

            The findings revealed the successful development of a care and referral model for STEMI patients at Wapipathum Hospital. Key outcomes included an increase in the door-to-needle time rate within 30 minutes from 64.53% to 93.75% and an increase in the door-to-balloon time rate within 90 minutes from 90.59% to 92.31%. The percentage of STEMI patients receiving reperfusion within 30 minutes rose from 81.55% to 96.89%. Additionally, the proportion of STEMI patients arriving by EMS increased from 16.67% to 43.90%, and the mortality rate decreased from 10.42% to 4.88%. The care model was adhered to at 100%, and the professional nurses and interdisciplinary team reported high overall satisfaction.

Keywords : Care model, Referral system, Acute myocardial infarction