Development of Fast Pass Nursing Model for Acute Myocardial Infarction Patients undergoing Percutaneous Coronary Intervention

Abstract

Background: Nursing for acute myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI), a procedure that requires personnel with specialized expertise in patient care. From the situation of the year 2017-2019, patient care outcomes have not yet achieved the goals. The mortality rate was found at 10.9%, 14.6%, and 10.0%, respectively. The original model of nursing service is still unclear, and access to service is also delayed.
Objectives: This study aimed to develop and evaluate the outcomes of the Fast Pass Nursing model for STEMI patients undergoing PCI.
Study Design: Research and Development
Methods: From May 2022 to July 2023, the research process consisted of four stages of Fast Pass Nursing model: 1) a situational studying, 2) the model development stage, 3) the implementation of model stage, and 4) the evaluation stage with a sample group of 10 experts, 39 medical personnel, and 609 patients (data obtained from medical records and directly from patients) through the Surin Hospital Ethics Committee. Research tools for quality testing were a model of Fast Pass Nursing, a service quality record form, interview forms, suitability assessment form, a knowledge scale, an opinion questionnaire, a practice check, a satisfaction questionnaire, a behavioral questionnaire, and a life quality record form. Data were analyzed by using descriptive statistics with a content analysis. Percentage, mean, standard deviation and t-test were also performed for quantitative data.
Results: The Fast Pass Nursing model for STEMI patients undergoing PCI was developed. The results showed that after using the Fast Pass Nursing model for patients with STEMI undergoing PCI, it was found that professional nurses had a high level of satisfaction (=4.7, SD=0.4) and 99.5% of nurses followed the model. In addition, Patients entering the Fast Pass increased from 65.6% to 77.0%. Onset to door time decreased from 123 minutes to 112 minutes. Door to EKG time decreased from 6 minutes to 4 minutes. Diagnosis to PCI time decreased from 85 minutes to 68 minutes. Mortality rate also decreased from 13.4% to 6.3%. The patient's knowledge score was significantly increased from 14.7 to 19.8 (p<0.001), including self-care behavior showed at a high level (=4.6, SD=0.2) with a good quality of life (=5.0, SD=0.8). The good satisfaction with the service was found at a high level. (=4.8, SD=0.3).
Conclusion: A Fast Pass Nursing model for STEMI patients undergoing PCI helped to promote the patient care process following the standard, thus enabling patients to access to coronary artery catheterization services quickly, having a good quality of life, and reducing a mortality rate.