Development of nursing guidelines for patients with Acute Coronary Syndrome Emergency department, Nakhu Hospital, Kalasin Province.

Abstract

     This research and development study aimed to formulate nursing practice guidelines for patients with acute coronary artery disease (ACAD) in the Accident and Emergency Department of Nakhu Hospital, Kalasin Province. Conducted over 12 months from October 2022 to September 2023, the study focused on a purposive sample of 12 nurses from the department. Utilizing tools such as the development process for ACAD nursing guidelines, patient care recording forms, nursing practice recording forms, and a questionnaire gauging nurses' opinions on the guidelines, the data were subjected to content analysis, descriptive statistics, and inferential statistics, including a dependent t-test.

      The findings revealed a significant advancement in ACAD nursing guidelines during the second stage, involving streamlined procedures and a modified referral system to Sakon Nakhon Center Hospital. Emergency department nurses displayed notable improvements in their opinions regarding the feasibility of adhering to the new guidelines, with statistically significant differences observed before and after implementation (p < .001). The enhanced guidelines facilitated prompt and accurate patient care, leading to a 100% diagnosis rate within 1-10 minutes of admission. Specifically, 66.66% of cases were diagnosed with STMEMI and 33.33% with NSTEMI, resulting in timely referrals for Primary PCI within 120 minutes of STEMI diagnosis.