Impact of the Participation in the Fast Tract STEMI Project on the Mortality of Patients with Acute Myocardial Infarction, Nangrong Hospital, Buriram

Abstract

Acute myocardial infarction is serious, acute illness causing sudden deaths of the patients. Rapid access to services and urgent medication with streptokinase could increase the chance of survival. To address the high incidence of the disease, Nangrong Hospital of Burirum province had participated in the fast tract STEMI project of Maharat Nakornrachasima Hospital in order to expedite medical care process. The objective of this study was to assess the impact of participation on treatment procedures, the outcomes and the case fatality. The study was conducted as a quasi-experimental research during May 2010 – April 2011. The study samples were 73 patients with acute myocardial infarction who fit with the eligible criteria. Assessment was performed quarterly based on the data collected from hospital records, STEMI management forms, meeting records and data on related treatment events. It was found that 68.75% of patients who needed drugs were able to get drug (door to needle time) within 30 minutes (compared to zero percent before the participation); and the fastest record was within 10 minutes. Case fatality was 2.74 which occurred during transportation. Therefore, the model which was comprised of clear and precise written management system, on-duty preparedness, teamwork, and holistic care provision, could be a prototype for improving care to patients with acute myocardial infarction; and should be widely promoted.