Effectiveness of a nurse training intervention in the emergency department to improve the diagnosis and treatment of stemi patients : EDUCAMI study
Berga Congost, Gemma (Institut de Recerca Sant Pau)
Brugaletta, Salvatore (Hospital Clínic i Provincial de Barcelona)
Valverde Bernal, Jonatan (Institut de Recerca Sant Pau)
Torralbas Ortega, Jordi (Institut de Recerca Sant Pau)
García Picart, Joan (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Arzamendi, Dabit (Institut de Recerca Sant Pau)
Puig Campmany, Mireia (Institut de Recerca Sant Pau)
Garcimartin, Paloma (Hospital del Mar (Barcelona, Catalunya))
Berrocal Comalat, Mariona (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Mena Mejías, Sonia (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Muñoz Millán, Lorena (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Rodriguez Evangelista, Selma (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Ruiz Gabalda, J. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Jiménez Kockar, Marcelo (Institut de Recerca Sant Pau)
Martínez Momblán, Ma. Antonia (Universitat de Barcelona)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2025
Resum:	Background: Clinical practice guidelines for acute coronary syndrome recommend an interval between electrocardiogram (ECG) and balloon of <60 min in patients attending the emergency department (ED) of a hospital with primary angioplasty capacity. Compliance with this can be complex, especially in atypical presentations. Objective: To assess the effectiveness of specific training for ED triage nurses in reducing ECG-balloon time in STEMI. Methods: Quasi-experimental study with a pre-test-post-test design. In June 2021, a training intervention was implemented in the diagnosis of STEMI in the ED. The EDUCAMI program included complex presentations, emphasising disparities in women and elderly people. A historical sample was compared with a post-intervention sample. All patients consecutively activated as code STEMI in the ED were included, excluding those activated out-of-hospital. The main variable was ECG-balloon time, which was compared according to sex and age. Results: The final sample consisted of 447 patients distributed into historical sample (n = 327) and post-test groups (n = 120). A reduction from 88 (65-133) to 60 (50-116) minutes in ECG-balloon time was observed in the post-test group together with a shorter hospital stay of 5 (3-8) vs 4 (3-5. 5) days (p = 0. 013). When comparing according to sex and age, a decrease in ECG-balloon time (p < 0. 001) was observed in men and patients under 65 years of age (p < 0. 001). Conclusions: The training intervention proved effective, reducing the ECG-balloon time by 32 %. EDUCAMI reduces the time in men and young people, however, the bias persists in women and those over 65 years of age.
Ajuts:	Generalitat de Catalunya SLT008/18/00052
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Education ; Electrocardiogram-to-balloon ; Emergency department ; Nurses ; STEMI ; Training ; Triage
Publicat a:	Heart and Lung, Vol. 70 (January 2025) , p. 305-312, ISSN 1527-3288

DOI: 10.1016/j.hrtlng.2025.01.006
PMID: 39813828

8 p, 1.0 MB

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