Document Detail

Effect of implementing an acute myocardial infarction guideline on quality indicators.
MedLine Citation:
PMID:  24136764     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To evaluate the compliance rates to quality of care indicators along the implementation of an acute myocardial infarction clinical practice guideline.
METHODS: A clinical guideline for acute myocardial infarction was introduced on March 1st, 2005. Patients admitted for acute myocardial infarction from March 1st, 2005 to December 31st, 2012 (n=1,431) were compared to patients admitted for acute myocardial infarction before the implementation of the protocol (n=306). Compliance rates to quality of care indicators (ASA prescription on hospital admission and discharge, betablockers on discharge and door-to-balloon time) as well as the length of hospital stay and in-hospital mortality were compared before and after the implementation of the clinical guideline.
RESULTS: The rates of ASA prescription on admission, on discharge and of betablockers were higher after guideline implementation: 99.6% versus 95.8% (p<0.001); 99.1% versus 95.8% (p<0.001); and 95.9% versus 81.7% (p<0.001), respectively. ASA prescription rate increased over time, reaching 100% from 2009 to 2012. Door-to-balloon time after versus before implementation was of 86(32) minutes versus 93(51) (p=0.20). The length of hospital stay after the implementation versus before was of 6(6) days versus 6(4) days (p=0.34). In-hospital mortality was 7.6% (before the implementation), 8.7% between 2005 and 2008, and 5.3% between 2009 and 2012, (p=0.04).
CONCLUSION: The implementation of an acute myocardial infarction clinical practice guideline was associated with an increase in compliance to quality of care indicators.
Marcia Makdisse; Marcelo Katz; Alessandra da Graça Corrêa; Luciano Monte Alegre Forlenza; Marco Antonio Perin; Fábio Sândoli de Brito Júnior; Teresa Cristina Dias Cunha Nascimento; Ivanise Maria Gomes; Marcelo Franken; Marcos Knobel; Antonio Eduardo Pereira Pesaro; Oscar Fernando Pavão Dos Santos; Miguel Cendoroglo Neto; Claudio Luiz Lottenberg
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Publication Detail:
Journal Detail:
Title:  Einstein (Sao Paulo, Brazil)     Volume:  11     ISSN:  2317-6385     ISO Abbreviation:  Einstein (Sao Paulo)     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101281800     Medline TA:  Einstein (Sao Paulo)     Country:  -    
Other Details:
Languages:  ENG; POR     Pagination:  357-363     Citation Subset:  -    
Vernacular Title:
Efeito da implementação de um protocolo assistencial de infarto agudo do miocárdio sobre os indicadores de qualidade.
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