The importance of organizational variables in treatment time for patients with ST-elevation acute myocardial infarction improve delays in STEMI
Berga Congost, Gemma (Institut d'Investigació Biomèdica Sant Pau)
Brugaletta, S. (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Valverde Bernal, Jonatan (Institut d'Investigació Biomèdica Sant Pau)
Márquez López, Adrián (Institut d'Investigació Biomèdica Sant Pau)
Ruiz Gabalda, J. (Institut d'Investigació Biomèdica Sant Pau)
Garcia-Picart, Joan (Institut d'Investigació Biomèdica Sant Pau)
Puig Campmany, Mireia (Institut d'Investigació Biomèdica Sant Pau)
Martínez-Momblán, María Antonia (Centro de Investigación Biomédica en Red de Enfermedades Raras)

Fecha:	2021
Resumen:	Background: The time between arrival at the emergency department (ED) and balloon (D2B) in STEMI is one of the best indicators of the quality of care. Our aim is to describe treatment times and evaluate the causes of delay. Methods: This is an observational retrospective study, including all consecutive STEMI code patients ≥18 years old treated in the ED from 2013 to 2016. All the patients were stratified into two groups: delayed group with D2B > 70 min and non-delayed ≤70. The primary variable was D2B time. Findings: In total 327 patients were included, stratified according to their D2B as follows: 166 (67·48%) in the delayed group and 80 (32·52%) in the non-delayed group. The delayed group was older (p = 0·005), with more females (p = 0·060) and more atypical electrocardiogram (ECG) STEMI signs or symptoms (p = 0·058) (p = 0·087). Predictors of shorter D2B time were: typical STEMI ECG signs and short training sessions for nurses on identifying STEMI patients. Interpretation: There are delays particularly in specific groups with atypical clinical presentations. Short training sessions aimed at emergency nurses correlate with shorter delay. This suggests that continuing training for emergency nurses, along with organizational strategies, can contribute to increasing the quality of care. Clinical trial number: NCT04333381.
Ayudas:	Agència de Gestió d'Ajuts Universitaris i de Recerca SLT008/18/00052
Derechos:
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Myocardial infarction ; STEMI ; Nurses ; Triage
Publicado en:	Australasian Emergency Care, Vol. 24 Núm. 2 (june 2021) , p. 141-146, ISSN 2588-994X

DOI: 10.1016/j.auec.2020.10.001
PMID: 33199195

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