Desempenho dos indicadores de qualidade da assistência na fase aguda do infarto do miocárdio

• Autor(a) principal: Boaventura, Rafaela Peres
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• dARK ID: ark:/38995/0013000001r92
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/5598
• topic: Infarto do miocárdio; Angioplastia transluminal percutânea coronária; Tempo; Diagnóstico tardio; Qualidade da assistência à saúde; Enfermagem; Myocardial infarction; Angioplasty, balloon, coronary; Time; Delayed diagnosis; Quality of health care; Nursing; CIENCIAS DA SAUDE::ENFERMAGEM

This study aimed to analyze the pre-hospital course of patients undergoing percutaneous myocardial reperfusion in acute myocardial infarction and evaluate the performance of health care quality indicators of myocardial infarction in these patients. This is a retrospective cohort study with convenience sample. It was analyzed 39 cases of myocardial infarction with ST segment elevation, with Delta T up to 12 hours without previous administration of fibrinolytic agents, admitted for treatment at the General Hospital of Palmas / TO in 2013. Data were collected in the pre-hospital phase in records and interview and in the in-hospital phase through secondary data. For statistical analysis we used the Shapiro-Wilk test, Student's t test and ANOVA with 5% significance level. Most were male (76.9%), with a stable partner (74.4%), with up to nine years of education (64.1%) and at least three cardiovascular risk factors (79.5%). In the pre-hospital delta T phase was high (06h34min ± 03:14) and 10.2% achieved the recommended metric. The delta T was higher among patients that did not previously recognized symptoms of AMI (mean 07h09min ± 03h12min) and lower among those who were treated during the day (mean 03h 25min ± 05h35min). In-hospital phase, 56% were admitted during the day. In 30.8% of cases the Killip Kimball was > I. Among the other infarcted walls prevailed the bottom wall. Five patients (12.8%) died. Time door-ECG and needle holder did not follow international recommendations for all variables. The early recognition of symptoms and time of care are interfering for prehospital delay. There was no statistical correlation-balloon time and door-ECG door to the profile of patients with clinical variables in the hospitalization phase. The metric assessment of infarct treatment quality indicators in the acute phase was unsatisfactory throughout the study period.