Management of the acute cardiac patient in the Australian rural setting: a 12 month retrospective study.

Autor: Clune SJ; La Trobe Rural Health School, La Trobe University, Wodonga 3689, Australia. Electronic address: s.clune@latrobe.edu.au., Blackford J; School of Nursing & Midwifery, La Trobe University, Bundoora 3086, Australia. Electronic address: J.Blackford@latrobe.edu.au., Murphy M; La Trobe University Clinical School of Nursing @ Austin Health, Heidelberg 3084, Australia. Electronic address: maria.murphy@latrobe.edu.au.
Jazyk: angličtina
Zdroj: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses [Aust Crit Care] 2014 Feb; Vol. 27 (1), pp. 11-6. Date of Electronic Publication: 2013 Apr 06.
DOI: 10.1016/j.aucc.2013.03.002
Abstrakt: Background: Rural cardiac patients may require transfer to tertiary health services for ongoing acute cardiac management. The time required to transfer is a consideration in determining appropriate clinical care. There is little published data reporting acute cardiac management in the Australian regional setting that reviews factors determining transfer to a tertiary centre.
Purpose: This paper reports the findings of a quantitative, retrospective study conducted to identify demographic differences and potential predictors to urban transfer for ongoing acute cardiac management for patients presenting to a regional hospital with suspected acute myocardial infarction.
Methods: Using a purpose designed tool an audit of 204 files from June 2009 to July 2010 was conducted for all patients admitted to a regional hospital having a discharge diagnosis of acute myocardial infarction or angina. Patient demographics, clinical outcomes, concordance with treatment guidelines, and possible predictors of treatment decisions were investigated.
Findings: Patients younger than 65 years (p<0.001), unemployed (p<0.01) and with acute electrocardiograph changes (p<0.01) were more likely to be transferred to a tertiary centre. Treatment guidelines concordance for acute cardiac care ranged from 70% to 79% for all patients.
Conclusions: Although presenting patients were treated in a timely manner consistent with national guidelines, to be younger, unemployed or have electrocardiograph changes was a greater predictor to urban transfer. It is unknown if these differences in transferring or not to a tertiary centre contribute to poorer long-term cardiac outcomes for rural patients. Further evaluations are warranted.
(Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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