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Adherence to treatment guidelines for patients with chest pain varies in a nurse-led prehospital ambulance system.

Byrsell, Fredrik; Regnell, Mattias and Johansson, Anders LU (2012) In International Emergency Nursing 20(3). p.162-166
Abstract
INTRODUCTION:

Studies have shown that adherence to prehospital treatment guidelines, for patients with non-traumatic chest pain is incomplete and that there is a gender difference in treatment provided.



PURPOSE:

The aim of this study was to examine adherence to guidelines in a nurse-led ambulance system in southern Sweden.



METHOD:

Retrospective cohort study, including 862 medical records was reviewed. Data relevant to treatment guidelines was obtained e.g. the provision of oxygen, acetylsalicylic acid, glycerin trinitrate, electrocardiogram recorded, pain assessment, patient gender and time of day. Results were presented using descriptive statistics and adherence to present... (More)
INTRODUCTION:

Studies have shown that adherence to prehospital treatment guidelines, for patients with non-traumatic chest pain is incomplete and that there is a gender difference in treatment provided.



PURPOSE:

The aim of this study was to examine adherence to guidelines in a nurse-led ambulance system in southern Sweden.



METHOD:

Retrospective cohort study, including 862 medical records was reviewed. Data relevant to treatment guidelines was obtained e.g. the provision of oxygen, acetylsalicylic acid, glycerin trinitrate, electrocardiogram recorded, pain assessment, patient gender and time of day. Results were presented using descriptive statistics and adherence to present guidelines was described as poor (⩽20%), fair (21-40%), moderate (41-60%), good (61-80%) and very good (81-100%).



RESULTS:

The medical records included 401 women and 461 men. Twenty-three percent of the patients received ⩾10L/min of oxygen (men vs. women, P<0.81). Sixty-nine percent received treatment with sublingual glyceryl trinitrate, whereas 58% received acetylsalicylic acid (men vs. women, P<0.004). In 95% a twelve lead electrocardiogram was recorded. Pain assessment was performed in 40% before treatment (men vs. women, P<0.011). A significant difference between men and women was found in Time of onset (P<0.013).



CONCLUSIONS:

We conclude that adherence to treatment guidelines varies greatly among the variables studied, ranging from fair (⩾10L/min of oxygen) to very good (obtaining electrocardiogram). There were differences in treatment provided between women and men. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Emergency Nursing
volume
20
issue
3
pages
162 - 166
publisher
Elsevier
external identifiers
  • pmid:22726948
  • wos:000208852800008
  • scopus:84862663151
ISSN
1878-013X
DOI
10.1016/j.ienj.2011.08.004
language
English
LU publication?
yes
id
f087224d-e4f1-4f4d-a4ca-b051936625eb (old id 2859077)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22726948?dopt=Abstract
date added to LUP
2012-07-04 19:18:37
date last changed
2017-01-01 07:31:55
@article{f087224d-e4f1-4f4d-a4ca-b051936625eb,
  abstract     = {INTRODUCTION:<br/><br>
Studies have shown that adherence to prehospital treatment guidelines, for patients with non-traumatic chest pain is incomplete and that there is a gender difference in treatment provided.<br/><br>
<br/><br>
PURPOSE:<br/><br>
The aim of this study was to examine adherence to guidelines in a nurse-led ambulance system in southern Sweden.<br/><br>
<br/><br>
METHOD:<br/><br>
Retrospective cohort study, including 862 medical records was reviewed. Data relevant to treatment guidelines was obtained e.g. the provision of oxygen, acetylsalicylic acid, glycerin trinitrate, electrocardiogram recorded, pain assessment, patient gender and time of day. Results were presented using descriptive statistics and adherence to present guidelines was described as poor (⩽20%), fair (21-40%), moderate (41-60%), good (61-80%) and very good (81-100%).<br/><br>
<br/><br>
RESULTS:<br/><br>
The medical records included 401 women and 461 men. Twenty-three percent of the patients received ⩾10L/min of oxygen (men vs. women, P&lt;0.81). Sixty-nine percent received treatment with sublingual glyceryl trinitrate, whereas 58% received acetylsalicylic acid (men vs. women, P&lt;0.004). In 95% a twelve lead electrocardiogram was recorded. Pain assessment was performed in 40% before treatment (men vs. women, P&lt;0.011). A significant difference between men and women was found in Time of onset (P&lt;0.013).<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
We conclude that adherence to treatment guidelines varies greatly among the variables studied, ranging from fair (⩾10L/min of oxygen) to very good (obtaining electrocardiogram). There were differences in treatment provided between women and men.},
  author       = {Byrsell, Fredrik and Regnell, Mattias and Johansson, Anders},
  issn         = {1878-013X},
  language     = {eng},
  number       = {3},
  pages        = {162--166},
  publisher    = {Elsevier},
  series       = {International Emergency Nursing},
  title        = {Adherence to treatment guidelines for patients with chest pain varies in a nurse-led prehospital ambulance system.},
  url          = {http://dx.doi.org/10.1016/j.ienj.2011.08.004},
  volume       = {20},
  year         = {2012},
}