Clinical trial NCT04333381: Early Diagnosis of Acute Myocardial Infarction: Impact of an Educational and Organizational Intervention
Official title: Early Diagnosis of Acute Myocardial Infarction: Impact of an Educational and Organizational Intervention
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: STEMI
Myocardial Infarction
Nurses
Education
Emergency Room
Lead sponsor: Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Sponsor class: OTHER
First posted: 2020-04-03
Enrollment: 450
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Quasi-experimental design study, pre-post intervention type
Primary purpose: OTHER

Brief summary: The hypothesis is that an educational program aimed at emergency nurses and the implementation of measures at the organizational level reduce the time between arrival at the emergency room and the opening of the artery or balloon by 40% in patients attending for acute myocardial infarction.

Detailed description: The time between arrival in the emergency room (ER) and balloon time (D2B) in ST segment elevation myocardial infarction (STEMI) is one of the best indicators of quality care in patients with STEMI. Hospitals with more strategies to improve this quality of care have a shorter door-to-balloon time. The aim is to evaluate the effectiveness, in the time between the arrival in the ER and the balloon time, of an educational and organizational intervention for the early diagnosis of myocardial infarction for emergency nurses.

The aim of this study is to improve the time between arrival to ER and balloon time.

The study consists of two phases:

Phase I (PRE): in this phase, the aim is to describe the attendance times and to evaluate the causes of delay in attendance in STEMI patients. With the findings, a plan will be drawn up that includes the integration of an educational program for emergency nurses and organizational measures; oriented to improve the early diagnosis and delays in STEMI.

Phase II (POST): in this phase, the aim is to evaluate the effectiveness in improving delays in the care of patients with STEMI after the implementation of the educational and organizational intervention developed in phase 1. On the other hand, will evaluate the satisfaction of the emergency nurses with the training they received through educational and organizational intervention.

Eligibility criteria: Inclusion Criteria:

* Patients ≥18 years
* Admitted to the emergency room of the same center

Exclusion Criteria:

* Pregnant women
* Patients who did not receive coronariography were excluded

Primary outcomes:
measure: Door-to-balloon time (D2B)
timeFrame: up to 30 days; From the arrival at the emergency room to the balloon time up to discharge
Secondary outcomes:
measure: ER arrival-ECG time
timeFrame: up to 30 days; from the arrival at the emergency department to the ECG realization up to discharge
Other outcomes:
Locations:
city: Barcelona
country: Spain
facility: FGS Hospital de la Santa Creu i Sant Pau
Study officials:
References:
citation: Berga Congost G, Brugaletta S, Valverde Bernal J, Marquez Lopez A, Ruiz Gabalda J, Garcia-Picart J, Puig Campmany M, Martinez Momblan MA. The importance of organizational variables in treatment time for patients with ST-elevation acute myocardial infarction improve delays in STEMI. Australas Emerg Care. 2021 Jun;24(2):141-146. doi: 10.1016/j.auec.2020.10.001. Epub 2020 Nov 14.