Study of a nursing service model for patients with Non-ST Segment elevated acute coronary syndrome at Lampang Hospital

Abstract

Objectives This study aimed to examine the outcome of a nursing service model for patients with Non-ST segment elevated acute coronary syndrome (NSTE-ACS) at Lampang Hospital. Methods This research and development study, conducted between July 2019 and March 2020, was based on the concept of clinical governance. The subjects included 133 registered nurses and 275 NSTE-ACS patients. The study was divided into four phases: 1) situational analysis, 2) development of a nursing service model, 3) implementation of the model and 4) evaluation of the model. Data were collected using focus groups, questionnaires and patients records. Descriptive statistics and paired t-test were used in the analysis. Results Patient outcome categories consisted of time to emergency assessment (TEA), time to electrocardiogram (TEKG), receipt of timely emergency intervention (TEI), length of stay (LOS) and mortality rate. The average TEA and TEKG (in minutes) after implementation of the nursing service model decreased from 15.04 ± 11.12 to 9.26 ± 7.55 minutes and 17.84 ± 15.96 to 13.76 ± 9.46 minutes, respectively. Of the NSTE-ACS patients, 64.57% received TEI. LOS decreased from 6.32 ± 8.29 to 5.69 ± 4.30 days. The mortality rate was 5.71% compared to 9.80%, 13.78% and 9.48% in the three respective years preceding the study. Knowledge and skills of registered nurses increased significantly following implementation of the model (p < 0.001). Conclusion The specialist nursing services model for NSTE-ACS patients based on clinical governance was effective in improving the quality of care as well as nurses competencies.