The results of fast tract guideline and management in acute coronary syndrome patients at Nangrong Hospital

Abstract

Objective         :To compare the results between phase1 and phase2 after using fast   

                         tract management in acute coronary syndrome

:To study of route cause in multiproblems management

:To study clinical risk and specific clinical risk in acute coronary syndrome patients

Setting             : Nangrong Hospital

Research design          :Descriptive and prospective study

Methods          :A prospective study was made using  acute coronary syndrome patients at Nangrong Hospital 2 groups,Phase1 was using fast track management from 1 September 2007 to 30 April 2008 and Phase2 was using fast track management from 1 May 2008 to 31 August 2008.And then the results of this data study quality management, multiproblems, clinical risk, specific clinical risk and risk factor.

Results            :The clinical risk  was Complete history and physical exam(phase1-81.45%/phase2-87.5%), door to EKG(phase1-76.89/phase2-after90%), door to drug(in ASA phase1-71.16%/phase2-95%) (in Enoxaparin-Streptokinase phase1-89.02%/phase2-97.5%), lab reporting within 30-60 min(phase1-98.54%/phase2-97.5%), using high alert drug(phase1-68.67%/phase2-98.75%), detecting EKG by ICU nurse(phase1-75%/phase2-92.5%), complete discharge planning(phase1-34.71%/phase2-80%), unexpected death(phase1-1.66%/phase2-3.05%), safety for referring(phase1-100%/phase2-97.5%)

                        :The specific clinical risk was Killip classification class 3 was27%, Killip classification class 4 was 8.02%, VT/VF1.45%, AV Block2.18%,  AF 4.37%, SVT 1.45%, Atrial flutter 0.72%

Conclusion      :The fast tract management in acute coronary syndrome patients with develop skilling and team working can take care acute coronary syndrome patients to improved the quality management.The development of guideline in atypical angina patients and following in diabetes, hypertension, dyslipidemia and smoking patients may be decreased mortality in acute coronary syndrome patients in the future study.