Construction and application of a cluster management model for shortening FMC-to-B time in patients with acute myocardial infarction
Objective To construct a cluster management model that shortens the time from first medical contact to balloon(FMC-to-B)in patients with acute myocardial infarction(AMI),and analyze its application value.Methods By consulting relevant literatures and summarizing clinical work experiences,a cluster management model for shortening FMC-to-B time was constructed.A prospective randomized controlled study was conducted,selecting 121 AMI patients in Shangqiu First People's Hospital from January 2020 to January 2023 as the study subjects.The patients were divided into a control group and an observation group using the random number table method+sealed letter method.During the study period,the control group did not fall off,a total of 61 cases.There were 28 males and 33 females,aged 42-56(50.30±4.50)years,Killip cardiac function classification:32 cases of grade Ⅰ and 27 cases of grade Ⅱ,and routine nursing was used.In the observation group,1 case fell off due to delayed percutaneous coronary intervention(PCI),a total of 59 cases.There were 35 males and 24 females,aged 42-56(50.42±4.56)years,Killip cardiac function classification:37 cases of grade Ⅰ and 24 cases of grade Ⅱ.On the basis of the control group,the cluster management mode of shortening FMC-to-B time was used to intervene,the main contents were to build a medical team and establish a shortening FMC-to-B time model.The clinical indicators,treatment,complications,economic indicators and nursing satisfaction were compared between the two groups.Independent sample t test,x2 test,and rank sum test were used for statistical analysis.Results The AMI diagnosis time,FMC-to-B time,and catheter room activation time in the observation group were shorter than those in the control group[(582.61±10.36)s vs.(602.67±10.07)s,(110.61±9.48)min vs.(125.77±11.81)min,(19.85±3.94)min vs.(28.39±5.82)min],with statistically signiJicant differences(t=10.758,7.737,and 9.386,all P＜0.05).The revascularization rate of infarction and survival rate in the observation group were higher than those in the control group[94.92％(56/59)vs.83.61％(51/61),93.22％(55/59)vs.80.33％(49/61)],with statistically significant differences(x2=3.971 and 4.314,both P＜0.05).There was no statistically significant difference in the total incidence of complications between the two groups[13.56％(8/59)vs.18.03％(11/61)](x2=0.450,P＞0.05).The hospitalization time of the observation group was shorter than that of the control group,and the hospitalization cost was lower than that of the control group[(8.95±1.84)d vs.(10.95±1.51)d,(39 503.25±600.36)yuan vs.(43 981.22± 586.37)yuan],with statistically significant differences(t=6.519 and 41.335,both P＜0.05).The nursing satisfaction of the observation group was higher than that of the control group,with a statistically significant difference(Z=2.003,P＜0.05).Conclusion The construction and application of a cluster management model for shortening the FMC-to-B time of AMI patients can effectively shorten the AMI diagnosis time,FMC-to-B time,catheter room activation time,and hospitalization time,improve the vascular recanalization and survival rates,reduce the hospitalization costs,and improve the patients'nursing satisfaction.
J Acute myocardial infarctionCluster managementFirst medical contact to balloon time
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