Compilation and evaluation of clinical practice guidelines for comprehensive approaches to patients with acute chest pain in the emergency room at Al-Zahra Hospital in Isfahan

Resumen

Introduction & Aim: This study aimed to develop a standardof clinical guidelines for dealing with patients withacute chest pain in the emergency department at Al-ZahraHospital in Isfahan.Methods: In the first phase, a comprehensive approachand guidelines for patients with unstable angina referredto the emergency department, according to experts fromthe heart and emergency medicine and using valid sourceswas developed. In the second phase, the guidelines ereevaluated in a clinical trial. In this trial, 100 patients wererandomly assigned into intervention and control groups.The waiting time for the first visit, paraclinical measures,appropriate treatment; the physician’s satisfaction withtreatment, the patient’s admission to the emergencyroom, number of visits and treatment outcome; the patient’ssatisfaction from emergency services and treatmentoutcome were compared between two groups.Results: The mean of patients waiting time to receive thefirst visit, paraclinical measures, and appropriate treatmentin the intervention group were significantly lowerthan the control group (P-value<0.05). The mean of physician’ssatisfaction score from the treatment process, patient’sadmission to the emergency room, number of visitsand outcome of treatment in the intervention group wassignificantly higher than the control group (P-value<0.05).The mean patient satisfaction score from the emergencyservices in the intervention group was significantly higherthan the control group (P-value=0.0001).Conclusions: The developed guidelines for dealing withpatients with acute chest pain in the emergency roomsignificantly reduce the patient’s waiting time in receivingcare and improve the satisfaction of the physicians andthe patients.