Improving Nursing Care Quality for Patients with Acute Myocardial Infarction in the Critical Period: Approaches and Processes for Enhancing Healthcare Service Quality
Keywords:
Quality Improvement, Nursing Care, Myocardial Infarction, Critical Care, Patient Care ManagementAbstract
The development of nursing service quality in the care of patients with acute myocardial infarction during the critical phase is aimed at enhancing the effectiveness of patient care to reduce the risk of complications and increase the chances of survival. Patients with acute myocardial infarction in the critical phase require rapid and precise care to achieve optimal outcomes. Systematic nursing quality improvement can significantly reduce complications and increase survival rates. However, the provision of quality nursing services for this patient population continues to face several practice gaps, including the lack of standardized, specialized practice guidelines that align with evidence-based practices, discontinuous monitoring and evaluation systems that fail to utilize appropriate indicators, inadequate coordination among interdisciplinary healthcare professionals, and the absence of systematic personnel development programs. These deficiencies result in patient care that may not meet desired standards, particularly in critical time management, complication prevention, and continuity of care. This article therefore presents a conceptual framework for nursing quality improvement comprising seven main steps, from problem analysis to the establishment of a quality improvement culture within the organization. It includes specific implementation guidelines for patients with acute myocardial infarction during the critical phase, encompassing examples of measurable goal setting, specialized skill development, and appropriate technology utilization. The aim is to enable nursing professionals and administrators to develop efficient care systems, reduce complication risks, and elevate treatment quality to meet international standards sustainably. This will ultimately contribute to improved clinical outcomes, enhanced patient quality of life, and overall healthcare system efficiency.
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References
World Health Organization. Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Accessed December 2, 2024.
กองยุทธศาสตร์และแผนงาน สำนักงานปลัดกระทรวงสาธารณสุข. สถิติสาธารณสุข 2566. https://spd.moph.go.th/public-health-statistics. Accessed November 12, 2024
Takahashi J, Onuma S, Hao K, Godo S, Shiroto T, Yasuda S. Pathophysiology and diagnostic pathway of myocardial infarction with non-obstructive coronary arteries. J Cardiol. 2024;83(1):17-24. doi:10.1016/j.jjcc.2023.07.014.
Gong FF, Vaitenas I, Malaisrie SC, Maganti K. Mechanical complications of acute myocardial infarction: A review: A review. JAMA Cardiol. 2021;6(3):341-349. doi:10.1001/jamacardio.2020.3690.
Rae PJL, Pearce S, Greaves PJ, Dall’Ora C, Griffiths P, Endacott R. Outcomes sensitive to critical care nurse staffing levels: A systematic review. Intensive Crit Care Nurs. 2021;67(103110):103110. doi:10.1016/j.iccn.2021.103110
Al-Dorzi HM, Arabi YM. Quality indicators in adult critical care medicine. Glob J Qual Saf Healthc. 2024;7(2):75-84. doi:10.36401/JQSH-23-30
Jacobsen J, Bernacki R, Paladino J. Shifting to serious illness communication. JAMA. 2022;327(4):321-322. doi:10.1001/jama.2021.23695.
Falk AC. Nurse staffing levels in critical care: The impact of patient characteristics. Nurs Crit Care. 2023;28(2):281-287. doi:10.1111/nicc.12826
Oner B, Zengul FD, Oner N, Ivankova NV, Karadag A, Patrician PA. Nursing-sensitive indicators for nursing care: A systematic review (1997-2017). Nurs Open. 2021;8(3):1005-1022. doi:10.1002/nop2.654.
Cho H, Steege LM. Nurse fatigue and nurse, patient safety, and organizational outcomes: A systematic review. West J Nurs Res. 2021;43(12):1157-1168. doi:10.1177/0193945921990892.
Alharbi HF, Alzahrani NS, Almarwani AM, Asiri SA, Alhowaymel FM. doi:10.1002/nop2.654A cross-section study. Nurs Open. 2023;10(5):3253-3262. doi:10.1002/nop2.1577.
Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826. doi:10.1093/eurheartj/ehad191
Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of Chest Pain: A report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029
สมาคมแพทย์โรคหัวใจแห่งประเทศไทย ในพระบรมราชูปถัมภ์. แนวเวชปฏิบัติการดูแลรักษาผู้ป่วยภาวะหัวใจขาดเลือดเฉียบพลัน พ.ศ. 2563. http://www.thaiheart.org/images/introc_1599350902/Thai%20ACS%20Guidelines%202020.pdf. Accessed November 15, 2024
World Health Organization. Quality health services. https://www.who.int/news-room/fact-sheets/detail/quality-health-services. Accessed December 2, 2024.
Markazi-Moghaddam N, Balaye Jame SZ, Nikoomanesh M, Rezapour R. A systematic review and meta-analysis of Health Care quality in Iran based on the Comprehensive Quality Measurement in Health Care model. Int J Prev Med. 2023;14(1):10. doi:10.4103/ijpvm.ijpvm_238_21.
สถาบันรับรองคุณภาพสถานพยาบาล. การพัฒนามาตรฐานโรงพยาบาลและบริการสุขภาพ (HA). https://www.ha.or.th/TH/Contents/มาตรฐานโรงพยาบาลและบริการสุขภาพ%20(HA). Accessed December 2, 2024.
Chindy C, Diana D. Effect of a quality of care improvement initiative in patients with acute coronary syndrome. the int j of med science and health. 2024;2(8):1-12. doi:10.70070/x9xr6413.
Zhao D, Smith SC. Quality of care for patients with acute coronary syndrome. Cardiol Plus. 2021;6(4):202-209. doi:10.4103/2470-7511.334403.
Kanaoka K, Iwanaga Y, Tsujimoto Y, et al. Quality indicators for acute cardiovascular diseases: a scoping review. BMC Health Serv Res. 2022;22(1):862. doi:10.1186/s12913-022-08239-0.
นัชชา สุนทรสวัสดิ์, นฤมล อนุมาศ, ธิดารัตน์ เหลี่ยมไกร, ประณีต ส่งวัฒนา. การพัฒนาระบบการพยาบาลฉุกเฉินในผู้ป่วยภาวะกล้ามเนื้อหัวใจขาดเลือดเฉียบพลันชนิด STEMI งานอุบัติเหตุและฉุกเฉิน โรงพยาบาลหาดใหญ่. วารสารกองการพยาบาล. 2566;50(3):138-153.
Alkhaqani AL, Ali BRM. Evidence-based nursing care of patient with acute myocardial infarction: Case report. Int J Nurs Health Sci. 2022;4(1):1-7. doi:10.33545/26649187.2022.v4.i1a.31.
Liu J, Zhong Z, Ou S, Peng K. Application effect of evidence-based nursing in perioperative period of acute coronary syndrome. Am J Transl Res. 2021;13(4):2653-2661.
Berga Congost G, Brugaletta S, Garcimartin Cerezo P, et al. Effectiveness of a nurse training intervention in the emergency department to improve the diagnosis and treatment of stemi patients: EDUCAMI study. Heart Lung. 2025;70:305-312. doi:10.1016/j.hrtlng.2025.01.006.
Holmberg M. The EXPAND-model: A hermeneutical application of a lifeworld-led prehospital emergency nursing care. Nurs Sci Q. 2021;34(3):287-293. doi:10.1177/08943184211010456.
Posadas-Collado G, Membrive-Jiménez MJ, Romero-Béjar JL, et al. Continuity of nursing care in patients with coronary artery disease: A systematic review. Int J Environ Res Public Health. 2022;19(5):3000. doi:10.3390/ijerph19053000.
Rosa A, Trunfio TA, Marolla G, Costantino A, Nardella D, McDermott O. Lean Six Sigma to reduce the acute myocardial infarction mortality rate: a single center study. TQM J. 2023;35(9):25-41. doi:10.1108/tqm-03-2022-0082.
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