http://cardiologia.publicacionmedica.com/contenido/images/stemi_aha_2013.pdf

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

s in PubMed), and more liberal use of summary recommendation tables (with references that support LOE) to serve as a quick reference. In April 2011, the Institute of Medicine released 2 reports: Finding What Works in Health Care: Standards for Systematic Reviews and Clinical Practice Guidelines We Can Trust.2,3 It is noteworthy that the IOM cited ACCF/AHA practice guidelines as being compliant with many of the proposed standards. A thorough review of these reports and of our current methodology is under way, with further enhancements anticipated. The recommendations in this guideline are considered current until they are superseded by a focused update or the fulltext guideline is revised. The reader is encouraged to consult the full-text guideline for additional guidance and details about the care of the patient with ST-elevation myocardial infarction (STEMI), because the Executive Summary contains only the recommendations. Guidelines are official policy of both the ACCF and AHA. Jeffrey L. Anderson, MD, FACC, FAHA Chair, ACCF/AHA Task Force on Practice Guidelines O’Gara et al 2013 ACCF/AHA STEMI Guideline Executive Summary 533

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary

Preamble 2356

1. Introduction 2357

2. Overview of Acs 2358

3. Initial Evaluation and Management: Recommendations 2358

4. Early Hospital Care: Recommendations 2363

5. Myocardial Revascularization: Recommendations 2369

6. Late Hospital Care, Hospital Discharge, and Posthospital Discharge Care: Recommendations 2371

/pdf/2014-aha-acc-guideline-for-the-management-of-patients-with-z5d3l3bigd.pdf

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes: Executive Summary

Background: Disease management programs (DMPs) that use multidisciplinary teams and specialized clinics reduce hospital admissions and improve quality of life and functional status. Evaluations of cardiac DMPs delivered by home health nurses are required. Methods: Between August 1999 and August 2000 we identified consecutive patients admitted to hospital with elevated cardiac enzymes. Patients who agreed were randomly assigned to participate in a DMP or to receive usual care. The DMP included 6 home visits by a cardiac-trained nurse, a standardized nurses9 checklist, referral criteria for specialty care, communication with the family physician and patient education. We measured readmission days per 1000 follow-up days for angina, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD); all-cause readmission days; and provincial claims for emergency department visits, physician visits, diagnostic or therapeutic services and laboratory services. Results: We screened 715 consecutive patients admitted with elevated cardiac markers between August 1999 and August 2000. Of those screened 71 DMP and 75 usual care patients met the diagnostic criteria for myocardial infarction, were eligible for visits from a home health nurse and consented to participate in the study. Readmission days for angina, CHF and COPD per 1000 follow-up days were significantly higher for usual care patients than for DMP patients (incidence density ratio [IDR] = 1.59, 95% confidence interval [CI] 1.27–2.00, p p p p = 0.007), diagnostic or therapeutic services ( p = 0.012) and laboratory services ( p = 0.007). Interpretation: The results provide evidence that an appropriately developed and implemented community-based inner-city DMP delivered by home health nurses has a positive impact on patient outcomes.

/pdf/evaluation-of-a-community-based-inner-city-disease-3bcusyjeey.pdf

Evaluation of a community-based inner-city disease management program for postmyocardial infarction patients: a randomized controlled trial

Objectives To obtain home health nurses' comments on an evidence-based care pathway for post myocardial infarction. Design A qualitative design was used. Setting Culturally diverse, lower income area of a large city. Participants All home health nurses from one nursing agency who participated in a comparative study on the impact of the evidence-based care pathway. Results The largest number of comments made by the nurses were related to the beneficial impact of the pathway on the provision of quality nursing care and on increased job satisfaction. The home health nurses reported that the pathway increased clients' knowledge of medications and diet. In addition, they commented that they were able to use the pathway effectively because of the training they received from the inpatient cardiac nurses. Conclusions This qualitative study demonstrates the benefits of investing in the implementation of best practice guidelines by home health nurses. However, nursing associations, such as the Canadian Community Health Nurses Initiatives Group, will need to continue to champion for additional funds to support the additional expenses incurred.

Registered nurses' experiences with an evidence-based home care pathway for myocardial infarction clients.

The development of Partners for Health's integrated community pathway for postmyocardial infarction patients.

Sustainable evidence-based decision-making: A case study

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Evaluation of a community-based inner-city disease management program for postmyocardial infarction patients: a randomized controlled trial

Registered nurses' experiences with an evidence-based home care pathway for myocardial infarction clients.

The development of Partners for Health's integrated community pathway for postmyocardial infarction patients.

Sustainable evidence-based decision-making: A case study