Barriers in treating patients with acute coronary syndrome in Indonesia Primary Health Care: A phenomenological study

Abstract

Introduction: Acute Coronary Syndrome (ACS) is the leading cause of mortality in the world. Primary prevention strategy focuses on reducing the risk of disease spread. At the same time, curative strategy aims at reducing the risk of disability and mortality. Initial therapy should be considering early stabilization and immediate advanced care to reduce the risk of complication. Therefore, it is important to improve guidelines, the medical referral system, and family consent procedure to save patients with ACS. Aim: This research aimed at exploring the barriers faced by nurses in treating patients with ACS in Primary Health Care (PHC). Method: This research employed a qualitative research method using descriptive phenomenology.This study involving 16 subjects of nurses working in PHC with indepth interview . The data analysis procedure proposed by Clark and Brown 2013. Result: Three main themes were pointed out by 16 participants; 1) Update Guidlines, 2) Inefficient referral process to other health centers, 3) Consent making process by the family. Dicussion: Barriers in performing health care for patients with ACS in the emergency unit of PHC needs updating guidline to be enhanced by engaging the advancement of technology and communication using electronic medical record system, family education, and fulfillment of better medical facilities to make the process more efficient. At the same time, also improves the management service for patients with ACS and making it possible for PHC to provide reliable health care as the first health care provider for the society. Keywords: Barriers to care, Health Care Referral, Acute Coronary Syndrome, Emergency Nursing, Primary Health Care