{"title":"Effectiveness of a nurse training intervention in the emergency department to improve the diagnosis and treatment of stemi patients: EDUCAMI study.","authors":"Gemma Berga Congost, Salvatore Brugaletta, Paloma Garcimartin Cerezo, Jonatan Valverde Bernal, Mariona Berrocal Comalat, Sonia Mena Mejías, Lorena Muñoz Millán, Selma Rodriguez Evangelista, Judit Ruiz Gabalda, Jordi Torralbas Ortega, Joan Garcia-Picart, Marcelo Jimenez-Kockar, Dabit Arzamendi Aizpurua, Mireia Puig Campmany, María Antonia Martinez Momblan","doi":"10.1016/j.hrtlng.2025.01.006","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>To assess the effectiveness of specific training for ED triage nurses in reducing ECG-balloon time in STEMI.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"305-312"},"PeriodicalIF":2.4000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrtlng.2025.01.006","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
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.
期刊介绍：
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.
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