The Development of a Screening Protocol for Myocardial Infarction Patients at Kumphawapi Hospital, Udon Thani Province

Abstract

Effective screening of patients presenting with chest pain or other related-symptoms of myocardial infarction has a positive impact on patient treatment.  There were limitations in such screenings at Kumphawapi hospital, a secondary hospital in Udon Thani province, that needed to be overcome. This action research was aimed to develop a screening protocol for patients with myocardial infarction symptoms at Kumphawapi hospital. The participants were selected by purposive sampling and consisted of 7 registered nurses and 21 patients who met the inclusion criteria. The study was conducted from August 2023 to January 2024 and consisted of 4 phases: 1) the situation analysis, 2) protocol development, 3) protocol testing and 4) summarization and evaluation. The research measurements included the newly-developed screening protocol for patients with myocardial infarction symptoms which had content validity indexes of 0.80, satisfaction assessment forms for service recipients and service providers which had satisfactory content validity indexes of 0.82, and 0.86, respectively, and Cronbach's alpha coefficients of 0.88 and 0.86, respectively, along with a demographic interview form and open-ended, semi-structured questions. The qualitative and quantitative data were analyzed using content analysis and descriptive statistics, respectively.

The results were found that there were two protocols for screening patients with myocardial infarction symptoms, including a protocol for screening patients with typical chest pain and a protocol for screening patients with atypical chest pain. After implementing the protocols, it was found that 91.40% of patients received an accurate diagnosis and 85.60% received an EKG examination within 10 minutes. However, the duration of the time delay before receiving the appropriate drugs for treatment frequently took more than 30 minutes due to mostly being diagnosed with NSTEMI (85.60%). Most patients and nurses were satisfied with the protocols at the highest level. The study suggested that the new screening protocols for patients with ischemic heart disease allows screening nurses to be able to quickly and accurately identify patients for diagnosis and treatment, effectively.