The Development of a Care System for ST Elevation Myocardial Infarction at the Emergency Room, Wapipathum Hospital, Mahasarakham Province

Abstract

Purposes : To develop a care system for ST Elevation Myocardial Infarction patients who received streptokinase at the emergency room, Wapipathum Hospital, Mahasarakham Province.

Study design : Action research

Materials and Methods : The research participants were chosen by purposive sampling method which are 1) 21 STEMI patients and 2) 21 related service personnel. Research instruments were patient information recording forms and patient care compliance assessment forms. The data was analyzed by using descriptive statistics and content analysis. The study period was from October 2021 to September 2022, study period was divided into three phases: 1) situation analysis, 2) system development, and 3) evaluation.

Main findings : The situation analysis found that there were service problems in both the process and the result. At the phase of system development, there were three cycles related to 1) quick access to fast-track services, 2) triage tool development, 3) care development, 4) STEMI diagnosis and consultation system to confirm the diagnosis, 5) setting standards for giving Streptokinase and patient care, and 6) referral and evaluation. The evaluation phases found that 100% of the multidisciplinary team followed patient care guidelines. Results of patient care after development revealed that 100% of patients were triaged for chest pain. The average time from arrival at the hospital to electrocardiogram was 9.62 minutes, the time of ECG translating averaged 10.22 minutes, Diagnosis to Streptokinase receiving averaged 22.83 minutes, and the average time from onset to Streptokinase was 153.89 minutes. The patients were referred after receiving Streptokinase at 100%. A common complication was low blood pressure. The patients at 45 percent did not experience complications from drug allergic reactions. The patient's symptoms improved 100%.

Conclusion and recommendations : The study results indicated that the care system development for ST Elevation Myocardial Infarction was effective in helping them receive prompt and standard care.