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Guideline adherence among prehospital emergency nurses when caring for patients with chest pain: a prospective cohort study
Göteborgs universitet.
Göteborgs universtitet.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
Södra Älvsborgs Sjukhus, Region Västra Götaland, Sverige.
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2021 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, E-ISSN 1757-7241, Vol. 29, no 1, article id 157Article in journal (Refereed) Published
Abstract [en]

Background: The emergency medical services (EMS) use guidelines to describe optimal patient care for a wide range of clinical conditions and symptoms. The intent is to guide personnel to provide patient care in line with best practice. The aim of this study is to describe adherence to such guidelines among prehospital emergency nurses (PENs) when caring for patients with chest pain. Objective: To describe guideline adherence among PENs when caring for patients with chest pain. To investigate whether guideline adherence is associated with patient age, sex or final diagnosis of acute myocardial infarction on hospital discharge. Methods: Guideline adherence in terms of patient examination and pharmaceutical treatment was analysed in a cohort of 2092 EMS missions carried out in 2018 in Region Halland, Sweden. Multivariate regression was used to describe how guideline adherence is associated with patient age, sex and diagnosis on hospital discharge. Results: Guideline adherence was high regarding examination of vital signs (93%) and electrocardiogram (ECG) registration (96%) but lower in terms of pharmaceutical treatment (ranging from 28 to 90%). Adherence was increased in cases in which the patient ended up with acute myocardial infarction (AMI) as diagnosis on discharge. Patients with AMI were given acetylsalicylic acid by PENs in 50% of cases. Women were less likely than men to receive treatment with acetylsalicylic acid and oxycodone. Conclusions: Guideline adherence among PENs when caring for patients with chest pain is satisfactory in terms vital signs and ECG registration. Regarding pharmaceutical treatment guideline adherence is defective. Improved adherence is mainly associated with male sex in patients and a diagnosis of AMI on hospital discharge. Defective adherence excludes measures known to improve patients’ prognoses such as treatment with acetylsalicylic acid. © 2021, The Author(s).

Place, publisher, year, edition, pages
BioMed Central Ltd , 2021. Vol. 29, no 1, article id 157
Keywords [en]
Acute myocardial infarction, Chest pain, Emergency medical services, Guideline adherence, Guideline compliance
National Category
Cardiac and Cardiovascular Systems Health Sciences
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-26986DOI: 10.1186/s13049-021-00972-5ISI: 000712965100001Scopus ID: 2-s2.0-85118334412OAI: oai:DiVA.org:hb-26986DiVA, id: diva2:1616312
Note

Export Date: 2 December 2021; Article; Correspondence Address: Wibring, K.; Department of Ambulance and Prehospital Care, Varlabergsvägen 29, Sweden; email: kristoffer.wibring@gu.se

Available from: 2021-12-02 Created: 2021-12-02 Last updated: 2024-01-17Bibliographically approved

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Herlitz, Johan

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