Effectiveness of Practice Guideline Implementation for ST-Elevation Myocardial Infarction Patients Receiving Thrombolysis at Emergency Department of DokKhamTai Hospital
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This research and development aimed to develop and evaluate the effectiveness of the practice guideline for ST-elevation myocardial infarction patients receiving thrombolytic drugs at emergency department, DokKhamTai hospital during April, 2015 to September, 2018. The samples were: 37 ST-elevation myocardial infarction patients; and the care team comprising of 6 doctors and 13 nurses. Research instruments included: patient’ data recording forms; and assessment forms of the effectiveness and opinions toward the guidelines. The research comprised of 3 phases: (1) system and guideline development phase, included screening, STEMI fast-tract, specialist consultation, treatment & care, and referral guidelines; (2) guideline implementation phase, employed 1) action & observation by coaching and participation, 2) reflection by after action review (AAR), 3) re-planning and 4) summing up the practice guideline; and (3) evaluation the effectiveness of the practice guideline phase. Data were collected continuously during the fiscal year of 2015 to 2018. Descriptive statistics were used for data analysis. Results of the effectiveness of guideline implementation showed that patients received EKG screening within 10 minutes by 20.00, 36.36, 72.72 and 100.00%, respectively. Patients received thrombolytic drug within 30 minutes by 20.00, 50.00, 54.54 and 70.00%, respectively. They had no death case during treatment and refer. The care team followed the practice guideline increasingly by 20.00, 54.54, 81.81 and 100.00% respectively. The developed practice guidelines helped patients get access to the services in time, and resulted in reducing the patient’ death rate.
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