卫生保健工作者在管理心肌梗死门到球囊时间方面遇到的挑战：一项调查

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-09-08 DOI:10.1016/j.ienj.2025.101677

Amina Yasser Al Balushi , Lin Zhao , Karen Livesay

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Nurses and doctors in STEMI management face several challenges that result in a delay in DTB time.</div></div><div><h3>Aim</h3><div>To investigate challenges nurses and doctors encounter in managing Door to Balloon (DTB) time for ST-elevation Myocardial Infarction (STEMI) patients.</div></div><div><h3>Method</h3><div>An online survey using Qualtrics software was distributed to all nurses and doctors working in the Emergency Room and Cardiac Catheterization Laboratory at the study site, which included a total of 150 staff members. The survey was conducted in August 2023 and lasted for one month. The questionnaire online link was sent to the participants and filled out by them through their smartphones.</div></div><div><h3>Results</h3><div>A total of 83 nurses and doctors responded to the questionnaire. The survey revealed several challenges encountered by nurses and doctors in STEMI management from highest to lowest based on response items in the Likert scale. In ER, the reported challenges related to the ECG interpretation (mean = 33, 47.8 %), followed by Process (mean = 31.5, 45.6 %), Resources (mean = 30.0, 43.5 %), Communication (mean = 28.8, 41.7 %), and Healthcare setting (28, 40.6 %). In CCL, the most reported challenges were related to Communication (mean = 10, 71.4 %). 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引用次数: 0

摘要

st段抬高型心肌梗死（STEMI）需要积极和快速的医疗干预。门到球囊时间（DTB）延迟超过90分钟会导致心脏组织的进行性损伤，需要立即进行医疗干预，包括经皮冠状动脉介入治疗（PCI）。STEMI管理中的护士和医生面临着导致DTB时间延迟的若干挑战。目的探讨st段抬高型心肌梗死（STEMI）患者从门到球囊（DTB）时间管理中护士和医生面临的挑战。方法使用Qualtrics软件对研究现场急诊室和心导管实验室的所有护士和医生进行在线调查，其中包括150名工作人员。该调查于2023年8月进行，持续了一个月。在线调查问卷链接被发送给参与者，并由他们通过智能手机填写。结果共有83名护士和医生参与问卷调查。调查揭示了护士和医生在STEMI管理中遇到的几个挑战，根据李克特量表的回答项目从高到低。在急诊中，报告的挑战与ECG解释相关（平均= 33,47.8%），其次是过程（平均= 31.5,45.6%），资源（平均= 30.0,43.5%），沟通（平均= 28.8,41.7%）和医疗环境（28.8,40.6%）。在CCL中，报告最多的挑战与沟通有关（平均= 10,71.4%）。其次是资源（平均= 7.5,53.5%）和医疗保健环境（平均= 28,40.6%）。主要结果显示预测变量的任何显著关联的年龄组p值为0.612(21 - 30岁,平均3.31±0.95,31-40年,平均3.62±1.17,每周年,平均3.7±1.22),教育组p值为0.481(文凭3.60±1.23,本科3.33±0.97,3.79±1.18研究生),多年的经验组织p值为0.659,双尾(10年的经验3.65±1.23,3.65±1.23,超过10年的经验),通过心电口译课程认证组的知识变量p值为0.583，双尾组（通过心电口译课程认证3.62±1.16，未通过心电口译课程认证3.42±1.08）。同样,结果显示预测变量的任何显著关联的年龄p值为0.615(21 - 30岁,平均31.91±5.43,31-40年,平均32.61±6.38,每周年,平均30.31±8.08)教育组p值为0.325(文凭29.87±7.75,本科31.93±5.95,33.41±6.02研究生),多年的经验组织p值为0.813,双尾(32±6.283,10年的经验,超过10年的经验31.53±7.27),在GSE变量上，通过心电口译课程认证（p值为0.197），双尾(通过心电口译课程认证（31.17±6.83）和未通过心电口译课程认证（33.91±5.67）。结论急诊CCL护士和医生在STEMI患者DTB时间管理中遇到的挑战与心电解释技能、STEMI管理流程、设备不可用、团队沟通等因素有关。本研究得出的结论是，年龄、受教育程度、经验年数和心电图认证等因素与参与者的知识和GSE无关。

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Challenges encountered by healthcare workers in managing door-to-balloon time of myocardial infarction: A survey

Background

ST-segment elevation myocardial infarction (STEMI) demands aggressive and rapid medical intervention. Delays in Door-to-balloon time (DTB) of more than 90 min cause progressive damage to the cardiac tissue and require immediate medical intervention, including percutaneous coronary intervention (PCI). Nurses and doctors in STEMI management face several challenges that result in a delay in DTB time.

Aim

To investigate challenges nurses and doctors encounter in managing Door to Balloon (DTB) time for ST-elevation Myocardial Infarction (STEMI) patients.

Method

An online survey using Qualtrics software was distributed to all nurses and doctors working in the Emergency Room and Cardiac Catheterization Laboratory at the study site, which included a total of 150 staff members. The survey was conducted in August 2023 and lasted for one month. The questionnaire online link was sent to the participants and filled out by them through their smartphones.

Results

A total of 83 nurses and doctors responded to the questionnaire. The survey revealed several challenges encountered by nurses and doctors in STEMI management from highest to lowest based on response items in the Likert scale. In ER, the reported challenges related to the ECG interpretation (mean = 33, 47.8 %), followed by Process (mean = 31.5, 45.6 %), Resources (mean = 30.0, 43.5 %), Communication (mean = 28.8, 41.7 %), and Healthcare setting (28, 40.6 %). In CCL, the most reported challenges were related to Communication (mean = 10, 71.4 %). Followed by Resources (mean = 7.5, 53.5 %), and Healthcare setting (mean = 28, 40.6 %).

The primary outcomes showed no statistically significant association of predictable variables of Age groups with a p value of 0.612 (21–30 years, mean 3.31 ± 0.95, 31–40 years, mean 3.62 ± 1.17, 41–50 years, mean 3.7 ± 1.22), Educational groups with a p value of 0.481(Diploma 3.60 ± 1.23, Bachelor 3.33 ± 0.97, Postgraduate 3.79 ± 1.18), Years of experience groups with a p value of 0.659, two-tailed (10 years of experience 3.65 ± 1.23, and More than 10 years of experience 3.65 ± 1.23), and groups of certified with an ECG interpretation course with a p value of 0.583, two-tailed (Certified with an ECG interpretation course 3.62 ± 1.16 and not Certified with an ECG interpretation course 3.42 ± 1.08) on the Knowledge variable. Similarly, the outcomes showed no statistically significant association of predictable variables of Age with a p value of 0.615 (21–30 years, mean 31.91 ± 5.43, 31–40 years, mean 32.61 ± 6.38, 41–50 years, mean 30.31 ± 8.08) Educational groups with a p value of 0.325(Diploma 29.87 ± 7.75, Bachelor 31.93 ± 5.95, Postgraduate 33.41 ± 6.02), Years of experience groups with a p value of 0.813, two-tailed (10 years of experience 32 ± 6.283, and More than 10 years of experience 31.53 ± 7.27), certified with an ECG interpretation course with a p value of 0.197, two-tailed (Certified with an ECG interpretation course 31.17 ± 6.83 and not Certified with an ECG interpretation course 33.91 ± 5.67) on the GSE variable.

Conclusion

The study reveals challenges encountered the nurses and doctors in ER & CCL in managing DTB time for STEMI patients were related to factors like skills in ECG interpretation, the STEMI management process, equipment unavailability, and team communication. This study concluded that factors like age, education, years of experience, and ECG certification were not associated with the participants’ knowledge and GSE.

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.