Development of A Nursing Model for Patients with Acute Myocardial Infarction with ST-Segment Elevation (STEMI) In the Pandemic of The Coronavirus Disease 2019 Emergency Department Phraphutthabat Hospital

Abstract

          Background: Acute myocardial infarction with ST-Segment Elevation (STEMI) is the important cause of death for people worldwide. In Thailand founded mortality rates per 100,000 populations in 2018-2020 were 31.8, 31.0 and 32.6. and the severe outbreak of coronavirus disease 2019 were affected in fast track STEMI treatment and delayed vasodilation. Therefore, the researcher is interested in studying the nursing model.

          Objectives: To develop a nursing model for acute myocardial infarction patients with ST-Segment Elevation (STEMI) with in the situation of the coronavirus disease 2019 outbreak and study the effect of using the developed nursing model.

         Method: The Research and development was Purposive sampling for 2 sample groups consisting of 26 professional nurses of emergency department and 20 STEMI patients who received services at the emergency department. The research included 4 phases: 1) Situation Analysis 2) Developed a nursing practice guideline for acute myocardial infarction patients (STEMI) with in the pandemic of the coronavirus disease 2019 pandemic, 3) Implemented developed guidelines go to trial, 4) Implemented the Improved guidelines and evaluate them. 

          Results: After applying the nursing model of STEMI in the pandemic of the coronavirus disease 2019, professional nurses had a statistically significant increase in knowledge (P<. 01), Satisfaction with the implementation of the guideline at the highest level (Mean = 4.64, S.D. = 0.18), and have better clinical outcomes with door to EKG time < 10 minutes, equal to 85%, and door to needle time < 30 minutes, equal to 45%. Patients/family were satisfied with the services received at a high level (Mean = 4.36, S.D. =0.483)

         Conclusion: The use of nursing model for acute myocardial infarction (STEMI) in the pandemic coronavirus disease 2019 situation helps nurses to standardize and adjust nursing practices. Was consistent with the situation and treatment goals make patients safety. The coronary artery was opened by the Fibrinolytic drugs at the right time.