Development of Fast Track System for Patients with STEMI In Phra Nakhon Si Ayutthaya Province

Abstract

     The purpose of this participatory action research was to develop the fast track system for patients with STEMI in Phra Nakhon Si Ayutthaya province. This research was divided to 3 phases: 1) situation analysis of fast track system for patients with STEMI, 2) Fast track system development, and 3) Explore the factors and barriers of fast track system for patients with STEMI. The participants were 60 of doctors and professional nurses who work in Phra Nakhon Si Ayutthaya hospital and networks and 179 STEMI patients. The research was carried out from 1 October 2013-30 September 2015. Quantitative data were analyzed by descriptive statistics which were percentage, means, standard deviation, t-test and Mann Whitney. The qualitative data were analyzed by content analysis.
     The results revealed that the fast track system for patients with STEMI developed and met the standard of care in Phra Nakhon Si Ayutthaya province and networks especially in the early stage and crisis period. Mortality rate was decreased in 2015 = 7.61 percent and 10.35 percent in 2014 and mortality rate during transfer are zero. Rate of Door to needle time were 77.01 percent in 2015 and 78.26 percent in 2014.The compare of transfer period before and after development showed that transfer time in 2015 (=171.50, S.D.=39.69) was faster than 2014 ( =210.87, S.D.=58.71) in significance (p<.001). Door to needle time in 2015 ( =85.76, S.D.=34.56) was faster than 2014 (=156.14, S.D.=94.18) in significance (p=.016).
     The development of fast track system for patients with STEMI in Phra Nakhon Si Ayutthaya can transfer patients to high potential hospitals. Moreover, all patients will get the same standard of care to protect and decrease the risk. According to the results, the development of system led to availability of medical equipments, staff personal development, and fast track system network in Phra Nakhon Si Ayutthaya.