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Pre hospital indicators in assessing the quality of care for patients with acute coronary syndrome Translated title: Indicadores pré-hospitalares na avaliação da qualidade da assistência ao paciente com síndrome coronariana aguda Translated title: Indicadores pre hospitalarios para la evaluación de la calidad de la atención en pacientes con síndrome coronario agudo

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      Abstract

      Objective: to assess quality indicators related to the pre-hospital time for patients with acute coronary syndrome.Method: collection took place at a tertiary hospital in Paraná between 2012 and 2013, through interviews and a medical record review. 94 patients participated, 52.1% male, 78.7% who were over 50 years old, 46.9% studied until the fourth grade, 60.6% were diagnosed with acute myocardial infarction.Results: the outcomes were the time between the onset of symptoms and the decision to seek help with an average of 1022min ± 343.13, door-to-door 805min ± 181.78; and reperfusion, 455min ± 364.8. The choice to seek out care within 60 min occurred in patients who were having a heart attack, and longer than 60 min in those with a history of heart attack or prior catheterization.Conclusion: We concluded that the pre-hospital indicators studied interfered with the quality of care.

      Translated abstract

      Objetivo: avaliar os indicadores de qualidade relativos ao tempo de atendimento pré-hospitalar a pacientes com síndrome coronariana aguda.Método: a coleta ocorreu num hospital terciário do Paraná entre 2012 e 2013, por entrevista e análise de prontuário. Participaram 94 pacientes, sendo 52,1% homens, 78,7% com idade superior a 50 anos, 46,9% estudaram até a quarta série, 60,6% com diagnóstico de infarto agudo do miocárdio.Resultados: os desfechos foram tempo entre o início dos sintomas e decisão de procurar ajuda com média de 1022 min. ± 343,13, tempo porta-porta de 805 min. ±181,78; e reperfusão, 455 min ± 364,8. A procura pelo serviço em até 60 min. ocorreu em pacientes com infarto, e superior a 60 min., naqueles com história de infarto ou cateterismo prévio.Conclusão: Conclui-se que os indicadores pré-hospitalares estudados interferiram na qualidade da assistência.

      Translated abstract

      Objetivo: analizar los indicadores de calidad relacionándolos con el tiempo de la atención prehospitalarios en pacientes con síndrome coronario agudo.Método: se recolectaron en un hospital de complejidad terciaria de Paraná entre 2012 y 2013, mediante entrevista y análisis del prontuario. Participaron 94 pacientes, 52,1% hombres, 78,7%, mayores de 50 años; 46,9% había estudiado hasta el cuarto grado y 60,6% diagnosticado de infarto de miocardio.Resultados: el indicador tiempo promedio 343.13 y ±1022min entre el inicio de los síntomas y la decisión de buscar ayuda. El tiempo puerta-puerta fue 181,78 ± 805min; y la reperfusión, 364,8 ± 455min. La búsqueda del servicio con el diagnóstico de IAM fue inferior a 60min, y superior a 60 min el histórico de IAM o un cateterismo anterior.Conclusión: indicadores prehospitalarios interfieren en la calidad asistencial.

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      Most cited references 20

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      ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.

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        ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC).

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          Pre-hospital delay in patients with acute coronary syndrome: Factors associated with patient decision time and home-to-hospital delay

          Background Pre-hospital delays in patients experiencing acute coronary syndromes (ACS) remain unacceptably long. Aims To examine simultaneously a wide range of clinical, sociodemographic and situational factors associated with total pre-hospital delay and its two components. Methods Pre-hospital delay data were collected from 228 patients with ACS using patient's medical notes and semi-structured interviews. Total pre-hospital delay (symptom onset to hospital admission) was divided into 2 components: decision time (symptom onset to call for medical help), and home-to-hospital delay (call for help to hospital admission). Results Shorter total pre-hospital delays and decision times were associated with ST segment myocardial infarction (STEMI), recognizing symptoms as cardiac in origin, being married, symptom onset outside the home and the presence of a bystander. Shorter home-to-hospital delays were more likely among younger patients, those experiencing an STEMI, and patients reporting a greater number of symptoms. Initial contact with emergency medical services was related to shorter total delays and decision times. Conclusions Different factors were associated with shorter times in the 2 component phases. Greater understanding of the factors impacting on the component phases may help target interventions more effectively and reduce pre-hospital delays.
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            Author and article information

            Affiliations
            [1 ] Universidade Estadual de Londrina Brazil
            [2 ] Universidade Estadual de Londrina Brazil
            Contributors
            Role: ND
            Role: ND
            Role: ND
            Journal
            rgenf
            Revista Gaúcha de Enfermagem
            Rev. Gaúcha Enferm.
            Universidade Federal do Rio Grande do Sul. Escola de Enfermagem (Porto Alegre )
            1983-1447
            September 2015
            : 36
            : 3
            : 49-55
            S1983-14472015000300049
            10.1590/1983-1447.2015.03.50869

            http://creativecommons.org/licenses/by/4.0/

            Product
            Product Information: SciELO Brazil
            Categories
            NURSING

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