Efficacy of “STEMI Consultation Template” for Reduce door-to-needle Time at Community Hospital
Keywords:
STEMI, Consultation, DTN, SK, CCUAbstract
Background: STEMI patients at community hospital delays prescription streptokinase (SK),
door-to-needletime (DTN)more than 30 minutes, consequently the high mortality rate. Important
causes was inadequate and formless of consultation pattern to cardiologist at Uttaradit hospital center.
Objective: This action research aims to comparison Door-to-needle timeat community hospital before
and after used “STEMI Consultation Template”. Design, setting, and participantsThe research was
historical controlled intervention at community hospital
Methods: STEMI patients to Coronary Care Unit Uttaradit hospital center was carried out from July
2015 to April 2016 44 STEMI patients (control group) and May 2016 to April 2017 44 STEMI patients
(intervention group).Control group consulted STEMI case by Line application but not prescription steps
and material, new “STEMI Consultation Template” prescription steps and important material include
chest pain score, infarct position, killip classification and contraindication for SK and record DTN in
case record from.The data were analyzes using frequency, mean, percentage and adjust the differences
include gender, age, underlying disease, severity of disease, infarct position bypoissonmultiple regression.
Results: There were STEMI patients used “STEMI Consultation Template” decreased DTN 91.1±113.3
minutes lower than control group 208.2±106.6 minutes(p<0.001), then adjust the differences as
described above, the “STEMI Consultation Template” decreased DTN 117.7 minutes (p<0.001),
increased chance DTN within 30 minutes 8.9% (p=0.715)and decreased mortality rate 17%(p=0.503)
Conclusion All STEMI patients at community hospitalshould be used “STEMI Consultation Template”
consulted cardiologist at Uttaradit hospital center.Because increased chance DTN within 30 minutes.
Keywords: STEMI, Consultation, DTN, SK, CCU
References
thrombolysis for ST elevation myocardial infarction. Postgrad Medical Journal, 2013; 89: 335-339.
2. Ranasinghe W G et al. Treatment time and outcome of thrombolytic therapy with streptokinase for acute
ST Segment Elevation Myocardial Infarction (STEMI) in a District General Hospital of Sri Lanka. Journal of the
Ceylon College of Physicians, 2014; 45: 28-31.
3. Robert L. McNamara et al. Impact of Delay in Door-to-Needle Time on Mortality in Patients with ST-Segment
Elevation Myocardial Infarction. American Jorunal of Cardiology, 2007; 100(8): 1227–1232.
4. Glickman SW et al. Delays in fibrinolysis as primary reperfusion therapy for acute ST-Segment elevation
myocardial infarction. American Heart Journal, 2010; 159: 998-1004.
5. เกรียงไกร เฮงรัศมี. มาตรฐานการรักษาผู้ป่วยโรคกล้ามเนื้อหัวใจขาดเลือดเฉียบพลัน. สถาบันโรคทรวงอก [ออนไลน์] 2555
[อ้างอิง ธันวาคม2556], แหล่งที่มาhttp://www.cdi.thaigov.net/cdi/folder_a/folder_f/1aa.pdf
6. นิยดา อกนิษฐ์, สุชาดา วิภากานต์, สุภาณี สิทธิสาร. การพัฒนารูปแบบการพยาบาลผู้ป่วยโรคกล้ามเนื้อหัวใจตายเฉียบพลัน
ชนิด STEMI โรงพยาบาลกระบี่. วารสารกองการพยาบาล, 2556; 40(3): 70-84.
7. Roshen C Maharaj, Heike Geduld and Lee A Wallis. Door-to-needle time for administration of fibrinolytics
in acute myocardial infarction in Cape Town. South Africa Medical Journal, 2012;102: 241-244.
8. Sultana R et al. Door to needle time of streptokinase and ST segment resolution assessing the efficacy of
reperfusion therapy at Karachi Institute of Heart Diseases. Journal Ayub Medical College Abbottabad,
2010;22(1): 150-3.
9. พรเพ็ญ ทุนเทพย์. การพัฒนารูปแบบการจัดการดูแลผู้ป่วยกล้ามเนื้อหัวใจตายเฉียบพลันโรงพยาบาลสุรินทร์. วารสารการแพทย์
โรงพยาบาลศรีษะเกษ สุรินทร์ บุรีรัมย์, 2554; 26(2): 247-261.
10. Sarfaraz A Zahid et al. Door to Needle Time and its Impact on Successful Thrombolysis. Journal of
Rawalpindi Medical College, 2012;16(1): 3-5.
Downloads
Published
How to Cite
Issue
Section
License
The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.
