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Silvia M S Fonseca, Dayse Nadia A Barboza, Fernando Ferreira, Paulo A D Mendonca and Fernanda A Rianelli
Albert Schweitzer Municipal Hospital, Brazil
Posters & Accepted Abstracts: J Nursing Research and Practice
Statement of the problem: The diagnostic strategy of the Chest Pain Units (CPU) in tertiary Brazil’s private hospitals allowed individuals with chest pain of non-cardiovascular etiology to be investigated in less complex and costly locations, resulting in high earlier and safer hospitals with reduced diagnostic errors and hospitalizations unnecessary.
Fundamentals: This cost-effectiveness of health care quality encouraged the Albert Schweitzer Municipal Hospital (ASMP) medical emergency staff to join forces and embrace the idea of creating a clinical protocol of chest pain management, which would start at hospital triage. Patients with a moderate degree of suspicion would be separated from the others into a unique space within the emergency room, consisting of three hospital beds provided with continuous cardiac monitoring, noninvasive arterial blood pressure measurement, oximetry, cardiopulmonary resuscitation equipment and an exclusive nursing and medical.
Methodology & Theoretical Orientation: The Chest Pain Unit of ASMP was inaugurated on June 7th, 2018. Any patient who seek ASMP with A, B and C Chest Pains are routinely submitted to a first EKG in 10 minutes. Patients with an ST segment elevation Myocardial Infarction (MI) (Route 1) are sent to the CPU for thrombolysis with Alteplase. The others are classified as Route 2 based on Grace score.
Findings: 96 patients were admitted, 39 females, mean age 60 years and 57 males, mean age 54 years. Of the 96 hospitalized patients, 50 were discharged in less than 24 hours. The time of hospitalization was reduced from 72 to 12 hours.
Conclusion & Significance: Despite the short time of follow-up since CPU inauguration, this strategy proved to be safe and costeffective, with reduced unnecessary hospitalizations and hospitalization times. This pioneer experience was meant to be an example that despite all economic difficulties it is possible to save lives and spend less money.
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