Development of care integrated management model for the patients with ST-elevation myocardial infarction, Emergency room, Rajavithi Hospital
Keywords:
Care integrated management model, ST-elevation myocardial infarction, emergency roomAbstract
This research and development aimed to develop and study the effectiveness of a care integrated management model for patients with ST elevation myocardial infarction (STEMI). A simple random sampling method was used to recruit the sample of 90 STEMI patients and 46 professional nurses/paramedics. Research experimental instruments included a care integrated management model for the patients with ST-elevation myocardial infarction. Data was collected by satisfaction questionnaires, nursing practice observation forms, knowledge, and data recording forms. Data were collected during the period of June 2024 to January 2025. Descriptive statistics, chi-square test, and paired t-test were used to analyze the data.
The results revealed that the care integrated management model for STEMI patients comprises three pathways: 1) Narenthorn EMS unit, Rajavithi Hospital 2) self-arrival by patients, 3) transferred patients. After the experiment, the patients received EKGs within 10 minutes more than before at the significant level of .05 (p < 0.05). Patients received PPCI treatment within 90 minutes and received thrombolytic drugs within 30 minutes. No significant statistical differences were found before and after the use of the model (p > 0.05). Regarding the service providers, errors in patient triage decreased, and their knowledge of STEMI patients significantly increased (p < 0.05). The service providers' satisfaction with the model was high (M = 4.44, SD = 0.62).
The findings suggest that nurses and interdisciplinary teams can use the care integrated management model to improve the quality and efficiency of STEMI patient care.
References
American Heart Association [AHA]. (2025). 2025 Heart disease and stroke statistics at-a-Glance. Retrieved from https://www.heart.org/en/-/media/PHD-Files-2/Science-News/2/2025-Heart-and-Stroke-Stat-Update/2025-Statistics-At-A-Glance.pdf?sc_lang=en
Bernard, R. (2000). Fundamentals of biostatistics (5th ed.). New York: Duxbury Press.
Bloom, B. S. (1975). Taxonomy of education. New York: David McKay.
Choudhury, T., West, N. E., & El-Omar, M. (2016). ST elevation myocardial infarction. Clinical Medicine, 16(3), 277-282.
Donabedian, A. (1996). Tracing the foundations of conceptual framework for patient safety ontology a evaluating the quality of medical care. Milbank Mem Fund Q, 44(3), 166-206.
Furtado, R. H., Nicolau, J. C., & Berwanger, O. (2020). Systems of care for ST-segment elevation myocardial infarction: Challenges and opportunities. Global Heart, 15(1), 43.
Hina, A., Christopher, F., Rehan A. K., & Steven, M. (2024). Acute ST-segment elevation myocardial infarction (STEMI). Retrieved from https://pubmed.ncbi.nlm.nih.gov/30335314/
Ibanez, B., James, S., & Agewall, S. (2018). 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal, 39(2), 119-177.
Keawdoungtean, S. (2020). The effects of nursing care for clinical nursing practice guideline to acute ST elevation myocardial infarction patients at Khoksamrong hospital. Singburi Hospital Journal, 29(1), 81-92. [In Thai]
Khotnarin, C., & Keerathikhajorn, W. (2023). Development of provincial nursing network for acute ST-segment elevation myocardial infarction (STEMI) patients. Journal of Medicine and Health System Management of Khon Kaen Hospital, 1(2), 99-107. [In Thai]
Mahaboonpiti, P., Siritarungsri, B., & Banyati, P. (2017). The Development of care management model for patients with acute myocardial infarction, Cha Am Hospital, Phetchaburi Province. Journal of Nursing and Health Science, 11(3), 128-137. [In Thai]
Mahdjoubi, D. (2009). Four types of R & D. Texas: Research Associate IC2 Institute.
Ministry of Public Health. (2025). Thai ACS registry Retrieved from https://www.ncvdt.org/Default.aspx. [In Thai]
Patra, P. (2012). Sample size in clinical research the number we need. International Journal of Medical Science and Public Health, 1(1), 5-9.
Sahmaae, N., Phutkeaw, S., & Khanbo, K. (2021). The development of case management model in patients with acute myocardial infarction based on muslim context, Naradhiwasrajanagarindra Hospital. Princess of Naradhiwas University Journal, 14(1), 63-79. [In Thai]
Senuphai, W., Techato, P., & Damnoi, S. (2019). Development of a clinical nursing practice guideline for the acute ST elevation myocardial infarction patients in emergency department, Songklanagarind Hospital. Princess of Naradhiwas University Journal, 11(3), 63-79. [In Thai]
Srisakhot, K., & Thipwat, S. (2018). Development of case management model with ST-segment elevation myocardial infarction receiving thrombolytic drugs. Journal of Nursing and Health Care, 16(3), 232-242. [In Thai]
Suwansri, P. (2024). The development of screening nursing practice for patients with acute myocardial infraction at Kham Muang hospital, Kalasin province, Thailand. Journal of Health and Environment Education, 9(1), 729-736. [In Thai]
Swansburg, R. C., & Swansburg, R. J. (2002). Introduction to management and leadership for nurse manager (3rd ed.). Bostone: Jone & Bartlett.
The Heart Association of Thailand under The Royal Patronage of H. M The King. (2020). Thai acute coronary syndromes guidelines 2020. Samut Prakan: Nextstep D-Sign Limited Partnership. [In Thai]
Wongpimoln, B., Phemphul, C., Prachanpol, J., & Sittisena, N. (2023). Nursing care model for safety in STEMI patients receiving percutaneous coronary intervention, PCI, at Roi Et hospital. Journal of Nursing and Health Care, 41(1), 1-16. [In Thai]
World Health Organization [WHO]. (2010). Framework for action on interprofessional education & collaborative practice. Geneva, Switzerland: World Health Organization.
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