MEDSURG NURSING

Reducing Patient Delay in Seeking Treatment for Acute Myocardial Infarction

Christine M. Crumlish
Mary M. Hand

Although there have been tremendous strides in therapies for acute myocardial infarction (AMI), patients still do not receive these treatments in a timely manner, or sometimes not at all. One major reason is inadvertent delays by patients and by those with whom they consult about their symptoms. One of the National Heart Attack Alert Program's (NHAAP) goals is to reduce the morbidity and mortality associated with AMI through the rapid identification and treatment of at-risk individuals. Medical-surgical nurses can play a crucial role in ensuring that patients and their family members know how to recognize the signs and symptoms of a heart attack, what steps to take to get early and appropriate evaluation and treatment, and the potentially lifesaving benefits of this information.

Objectives This independent study offering is designed for nurses and other health care professionals who care for and educate adult patients regarding acute myocardial infarction (AMI). The multiple choice examination that follows is designed to test your achievement of the following educational objectives. After studying this offering, you will be able to:
1.	Describe current therapeutic approaches to managing patients with AMI.
2.	Identify three variables associated with patient/bystander delay in seeking care for signs and symptoms of an AMI.
3.	Cite two areas for patient counseling about early recognition and appropriate response to symptoms and signs of an AMI.

Approximately every 29 seconds, someone in the United States will suffer from a new or recurrent acute myocardial infarction (AMI) and every 60 seconds, someone will die (American Heart Association [AHA], 1998). Of the 500,000 coronary heart disease deaths that occur each year about half of those patients die suddenly, within 60 minutes of the onset of symptoms, and before they ever reach the hospital (National Heart, Lung, and Blood Institute, 1994).

In the last decade, significant advances have been made in treating AMI. Treatment modalities can now alter the course of an evolving AMI, thus preserving heart muscle function and decreasing the mortality and morbidity associated with this life-threatening condition. Consequently, the quality of life for AMI patients and their families can be improved substantially. In this review, the state of the science for treating emerging AMI and strategies to enhance patient, family, and provider compliance with national guidelines are presented.

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Christine M. Crumlish, PhD, RN, CCRN, CS, is Assistant Professor, Villanova University, College of Nursing, Villanova, PA. Mary M. Hand, MSPH, RN, is Coordinator, National Heart Attack Alert Program, National Heart, Lung, and Blood Institute, Bethesda, MD.

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