EffectivenessResearch On Optimization Of Nursing Process In STEMI Primary PCI Treatment

[Background]Acute myocardial infarction is one of the most common and serious cardiovascular emergency in clinic. The treatment effect and prognosis of acute ST segment elevation myocardial infarction (STEMI) are closely related to the treatment time. More and more domestic and foreign managers and related practitioners are paying attention to it in recent years, they carried out a wide range of basic research, epidemiological studies and discussion of clinical workflow management.Processes are key elements of modern management. Modern hospital management also requires nursing managers have the nursing management innovation continuously, achieve terminal control objectives and improve nursing quality and management level of treatment through the process of structure adjustment and link.Shandong university qilu hospital is one of the earliest hospitals which establish acute chest pain center in China, the emergency department carryout critical first aid and research of acute chest pain, with primary percutaneous coronary intervention of STEMI as the center point, including other non traumatic acute chest pain. Through the integration of comprehensive management of STEMI treatment and nursing process optimization reconstruction, to shorten the STEMI treatment time and the length of hospital stay, reduce the perioperative mortality and improve the prognosis, achieve the treatment management goals.[Objectives]To evaluate the effectiveness of the optimization of nursing process in acute ST-segment elevation myocardial infarction (STEMI) patients after emergency percutaneous coronary intervention(PCI).[Methods]337 STEMI patients who undergoing emergency PCI during 2011.08 to 2014.05 were divided into control group(n=128),experimental group A (n=98)and the experimental group B (n=111) according their admission time.the routine nursing care was given to the patients in control group; The optimized nursing care was given by nurses in the rescue room and catheter room/lab with standardized theory and skills trainingto the patients in the experimental group A.Further modiffied STEMI nursing workflow was performed and coronary heart disease outpatient follow-up and "love heart club "education system were established in the experimental group B.The quality indexes including the time interval between onset to the ergency treatment,time to activate the catheter room.D2B time,mean length of hospital stay,the up-to standard rate of D2B and in-hospital mortality were evaluated and compared among groups.[Results]Significantly statistical differences were observed among groups,recpectively (P< 0.05,group A vs.control;P<0.05,groups B vs.control;P<0.05,group A vs.group B). But D2D and perioperative mortality were non significantly statistical differences.[Conclusions]The application of optimized nursing process in acute ST-segment elevation myocardial infarction (STEMI) patients after emergency percutaneous coronary intervention(PCI) can effectively improve the nursing service quality,and obtain both economic and social benefits.It is worth of clinical popularizing.