Development of Nurses’ Competencies for Streptokinase Administration in Acute ST Elevation Myocardial Infarction Patients : The First Level Hospital, Health Region 10th Context

Abstract

Fibrinolysis treatment by Streptokinase (SK) in acute ST Elevation myocardial infarction patients (STEMI) reduces patients’ mortality rate. Nurse plays an important role for administration and caring the patients who were treated with SK. There were five hospitals (7.9%) in Health Region 10th context that could provide SK drugs. The objective of this study was to develop nurse’s competencies for Streptokinase administration in STEMI patients of 60 the First Level Hospital (F2), in Health Region 10th context. The continuous quality improvement (CQI) was conducted. The study tools included the SK training program for STEMI patients and nurses’ evaluation forms of knowledge and skill to management SK drug. There were three cycles of PDCA. The results in the first cycle found that nurses enhancing of knowledge and skills to read the EKG in STEMI patients, and has administered SK. As a result, F2 hospitals were able to increase the number of SK’s administer to 31.7 percent by 2014. The development of the second cycle showed that nurse’s skills referred the STEMI patients by using adhesive paddle and transcutaneous pacing correctly with the guidelines for SK. F2 hospitals were able to increase the number of SK’s administer to 61.9 percent by 2015. Development of the third cycle found that of the nurses’ competencies were enhancing that they can be as an EKG lecturer in their province, and F2 hospitals can provide 100 percent of the SK drug in 2016. The Rate of SK / PCI treatment increased 78.1%, 78.5 %, and 79.08 % in 2015, 2016 and 2017, respectively. STEMI patients were more likely to have access and safety to thrombolytic therapy and initiated STEMI patient care network in Health Region 10th context.