The importance of organizational variables in treatment time for patients with ST-elevation acute myocardial infarction improve delays in STEMI
Por:
Congost, GB, Brugaletta, S, Bernal, JV, Lopez, AM, Gabalda, JR, Garcia-Picart, J, Campmany, MP, Momblan, MAM
Publicada:
1 jun 2021
Ahead of Print:
1 jun 2021
Resumen:
Background: The time between arrival at the emergency department (ED) and balloon (D2B) in STEMI is one of the best indicators of the quality of care. Our aim is to describe treatment times and evaluate the causes of delay.
Methods: This is an observational retrospective study, including all consecutive STEMI code patients >= 18 years old treated in the ED from 2013 to 2016.All the patients were stratified into two groups: delayed group with D2B > 70 min and non-delayed <= 70. The primary variable was D2B time.
Findings: In total 327 patients were included, stratified according to their D2B as follows: 166 (67.48%) in the delayed group and 80 (32.52%) in the non-delayed group. The delayed group was older (p = 0.005), with more females (p = 0.060) and more atypical electrocardiogram (ECG) STEMI signs or symptoms (p = 0.058) (p = 0.087). Predictors of shorter D2B time were: typical STEMI ECG signs and short training sessions for nurses on identifying STEMI patients.
Interpretation: There are delays particularly in specific groups with atypical clinical presentations. Short training sessions aimed at emergency nurses correlate with shorter delay. This suggests that continuing training for emergency nurses, along with organizational strategies, can contribute to increasing the quality of care. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.
Filiaciones:
Congost, GB:
Hosp Santa Creu & Sant Pau, Intervent Cardiol Dept, Cardiol, Barcelona, Spain
St Pau Biomed Res Inst, Barcelona, Spain
Brugaletta, S:
Hosp Clin Barcelona, Intervent Cardiol Dept, Cardiol, Barcelona, Spain
Biomed Res Inst IDIBAPS, Barcelona, Spain
Bernal, JV:
Hosp Santa Creu & Sant Pau, Intervent Cardiol Dept, Cardiol, Barcelona, Spain
St Pau Biomed Res Inst, Barcelona, Spain
Lopez, AM:
Hosp Santa Creu & Sant Pau, Intervent Cardiol Dept, Cardiol, Barcelona, Spain
St Pau Biomed Res Inst, Barcelona, Spain
Gabalda, JR:
Hosp Santa Creu & Sant Pau, Intervent Cardiol Dept, Cardiol, Barcelona, Spain
Garcia-Picart, J:
Hosp Santa Creu & Sant Pau, Intervent Cardiol Dept, Cardiol, Barcelona, Spain
Campmany, MP:
St Pau Biomed Res Inst, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Emergency Dept, Barcelona, Spain
Momblan, MAM:
Univ Barcelona, Sch Nursing, Fac Med & Hlth Sci, Fundamental Care & Med Surg Nursing Dept, Barcelona, Spain
CIBER ER, Res Networking Ctr Rare Dis, Unit 747, Barcelona, Spain
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