Under the chest pain center mechanism, whether the nursing handover affects the nursing efficiency and the outcomes of patients with STEMI in the emergency department? A retrospective study

Abstract

Background: The period of nursing handover is still considered the high incidence period of adverse events because of distractibility of nurses’ attention, potential interruption, and unclear responsibilities, although the introduction of chest pain centers (CPC) in China has achieved great success in shortening the duration of nursing operations to significantly improve the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). However, under the CPC mechanism, the nursing efficiency and patients’ outcome whether affected by the nursing handover is still a knowledge gap in research. This is also the aim of this study. Methods: This retrospective study was conducted with data of STEMI patients from a tertiary hospital in the north of Sichuan Province in the Chinese Mainland from January 2018 to December 2019 through the Chinese CPC database. This hospital is also the largest chest pain center in the region which has 1,200 beds, including 80 emergency beds, and treats over 10,000 emergency patients annually. Then dived data into two groups based on patients’ arrival times. According to the nursing handover schedule of the participating emergency department, patients with STEMI who visited Emergency Department (ED) during the nursing handover were selected in the handover period group (n = 40), and STEMI patients in other periods were included in the non-handover period group (n = 191). Then items were selected for comparison according to relative studies and guidelines. Results: A total of 231 cases were enrolled, of which 40 cases (17.3%) were divided into the handover period group and 191 cases (82.6%) belonged to the non-handover period group. The results showed that the handover period group took significantly longer on items including FMC2BS (P < 0.001), BS2CBR (P = 0.004), CBR2FAD (P < 0.001), and D2W (P = 0.001) compared to the non-handover group, but there were no significant differences in D2FMC and FMC2FE as well as the outcomes of patients. Conclusion: Compared with the non-handover group, the handover group showed a significant delay in important nursing operations in the emergency department. Hospitals should reform relevant regulations for the nursing handover of CPCs to improve the nursing efficiency of patients with STEMI, ensuring better functioning of CPCs.