title: Success of audit in reducing the time taken to administer thrombolysis and aspirin in patients with acute myocardial infarction.
abstract: We assessed whether audit might reduce the time taken to give thrombolysis and aspirin in patients with acute myocardial infarction (N = 116). A retrospective analysis was performed of the sources of delay in giving the drugs (N-60) and the data were presented to clinical staff accompanied by guidelines aimed at eliminating delays. A prospective survey was undertaken (N = 56) after these interventions. Audit resulted in an overall 31% reduction (P = 0.013) in the time to administer thrombolysis (median 55 minutes [range 21-148] v 38 [15-155]): there was a 57% fall (P < 0.0001) in the time to record an electrocardiogram (14 minutes [4-34] v 6 [1-19]) and a 33% decrease (P = 0.047) in the time taken to begin thrombolysis in the coronary care unit (15 minutes [0-110) v 10 [5-70]). The time taken to give aspirin was also reduced (P = 0.001) from 58 minutes (15-400) to 15 (3-235). The time taken to administer thrombolysis and aspirin to patients admitted with acute myocardial infarction can be reduced by audit.
authors.affiliation: Department of Cardiology, Western General Hospital, Edinburgh.
authors.forename: P
authors.initials: P
authors.lastname: Currie
authors.forename: S M
authors.initials: SM
authors.lastname: Gray
authors.forename: T R
authors.initials: TR
authors.lastname: Shaw
authors.forename: I R
authors.initials: IR
authors.lastname: Starkey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage*; D016507:Cardiology Service, Hospital / Q000458:organization & administration / Q000592:standards*; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D010343:Patient Admission; D018579:Patient Selection; D012189:Retrospective Studies; D012606:Scotland; D018709:Statistics, Nonparametric; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000592:standards*; D013997:Time Factors
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase; D001241:Aspirin