The Development of nursing practice guidelines for caring acute coronary syndrome patients with ST segment elevation (STEMI) in accident-emergency department of Sri Songkhram Hospital, Sri Songkhram District, Nakhon, Phanom Province.

Abstract

This study aimed to develop nursing practice guidelines for the care of patients with ST-segment elevation myocardial infarction (STEMI) in the accident and emergency department of Srisongkhram Hospital, Nakhon Phanom Province, before transferring them to Sakon Nakhon Regional Hospital for percutaneous coronary intervention (PCI). The Iowa Model of Evidence-Based Practice was used to integrate evidence into practice. It was found that the number of STEMI patients has increased, and despite the use of teleconsultation, the mortality rate remains high. Therefore, it is necessary to develop guidelines emphasizing rapid and safe care. The guidelines were developed based on the synthesis of 16 evidence-based studies, emphasizing the critical role of nurses at every stage. Implementation in 10 patients revealed that all survived and underwent PCI within an average time of 90.2 minutes. Nurses showed high satisfaction with the guidelines, with 82.1% agreeing that they were practical and consequence from ECG within 10 minutes, administering fibrinolysis, and real-time coordination significantly reduced treatment time and improved survival rates. Recommendations include establishing these guidelines as standard policy, developing supportive tools, training nurses in ECG interpretation and fibrinolysis administration, and continuous follow-up care. This study reflects the success of applying evidence-based practice to enhance the quality of STEMI patient care in community hospitals and serves as a model for further adaptation in other healthcare settings.