The Development of Referral Models for Acute myocardial infarction STEMI in Mahasarakham Hospital.

Abstract

The purpose of this participatory action research was to develop a referral models for  patients with acute myocardial  infarction STEMI  in  Mahasarakham  Hospital. The samples consisted of all patients who received  the  referral and 11 professional nurses and 10 emergency medical technician  and emergency medical responder, Mahasarakham Hospital. The study was carried out during July 2015 to May 2016. Data were collected using qualitative and quantitative information. Qualitative information  were  examined using content analysis. Descriptive statistic were used to analyzed quantitative     information to obtain frequencies, percentage, and mean.

The result revealed that the referral models for patients with acute myocardial infarction    STEMI  developed and met the standard of care in Mahasarakham Hospital. The 1^stStep analyzing the situation by fogus group of 11 professional nurses, 10 emergency medical technician  and emergency medical responder, Mahasarakham Hospital using content analysis. as the result, some professional nurse who refer patients with acute myocardial infarction lack of  interpret EKG skill and nursing care skill in crisis periods  and medical equipment in ambulance cars unavailable. The 2^ndStep  referral models development used PAOR  cycle implemented in 3 cycle. 1^st cycle  to developed  competency of health professional skills. Consult skills guideline . and medical equipment . then reflected to result show  no referral practice guideline standard in transfer  phase and some medical unavailable . 2^nd cycle to developed problem from 1^st cycle, to developed referral practice guideline standard in transfer phase and prepare medical equipment to available. The reflected of this cycle show patients who are crisis recommend physician should be refer together and developed emergency ambulance safety. 3^rd cycle to developed emergency ambulance cars  safety, result show standard emergency ambulance cars  safety in referral phase by BWAGON. The 3^rd Step Evaluation to referral models the result of this study revealed that mortality rate during transfer are zero and unexpected events are zero. The development of referral model should include man material method and money. According to the results, the developed led decrease mortality rate during refer.

Key word : acute myocardial infarction, referral models