What is the relationship between nursing care and the quality of care for patients with myocardial infarction?

Quality Of Care of Nurses in the Coronary Unit to Patients with Myocardial Infarction.

Introduction to the Problem

The World Health Organization (WHO, 2020) points out that cardiovascular diseases (CVD) are a group of disorders of the heart and blood vessels being the leading cause of death worldwide, affecting to a much greater extent low and middle-income countries, more than 80% of deaths from this cause occur in those countries, according to an estimate, more than 17.5 million people died in 2019 and affected both sexes equally, however, 80% are preventable with a healthy diet, physical activity regulates, as well as verify and control risk factors such as hypertension, high cholesterol, and sugar levels or diabetes.

Acute myocardial infarction is characterized by the lack of oxygen in the myocardium due to insufficient coronary flow; its pathogenesis is related to an intraluminal thrombus that develops on an atherosclerotic plaque or atheroma plaque, which triggers the occlusion of the involved artery, the clinical picture is characteristic. It is accompanied by typical electrocardiographic and enzymatic alterations; the treatment has evolved in recent decades, from simple rest and the use of heparin to thrombolytic therapy and primary angioplasty, considered the treatment of choice in hospitals with adequate resources (Carrabba, 2019).

In the United States, the World Health Organization in 2018 recorded a mortality rate from cardiovascular disease and diabetes of 237 per 100,000 inhabitants, followed by Spain with 68 per 100,000 inhabitants and Mexico with 21 per 100,000 inhabitants. Thus, the annual number of deaths due to cardiovascular diseases is expected to increase from 17 million in 2018 to 25 million in 2030 (WHO, 2019). In the United States, studies have indicated that the mean age ranges from 36 to 96 years and that 13, 3% did not have conventional cardiovascular risk factors and that 75% of cases presented typical pain (retrosternal pain, oppressive, severe, with or without radiation), a total of 117 patients were admitted to Columbia University Division Of Cardiology in 2019; therefore, cardiology nurses had to assist patients with myocardial infarction, in such a way that cardiovascular diseases constitute one of the most important causes of morbidity and mortality.

Clearly Identify the Problem

Cardiology Nursing is currently at a threshold of social relevance since cardiovascular diseases have become the leading causes of death and disability in the world; they present as an acute coronary ischemic syndrome, triggering unstable angina or acute infarction of myocardium (AIM) that is pathologically translated by the existence of necrosis in an area of the heart muscle and associated with some risk factors such as hypercholesterolemia, arterial hypertension, smoking and diabetes Mellitus among others (Hariprasath, 2018). The main objective of the treatment of infarction is to avoid the death of the patient, the necrosis of the ischemic myocardium at risk, and its extension, thus avoiding the appearance of complications, making highly specialized nursing care necessary for patients with myocardial infarction in about clinical manifestations, assessment, care planning, and evaluation, as well as in teaching the patient and his environment (Boerma, 2019).

In this regard, the Coronary Unit constitutes a section of hospitals endowed with material resources, technicians, and highly specialized nurses who must provide comprehensive care with an ethical attitude to critical patients, whose pathological condition puts their lives at severe risk and who present reversible conditions that make the application of monitoring, surveillance, management, and advanced life support necessary (Mohammed et.al, 2020). Thus, nursing care is of the highest level and is provided 24 hours a day with the provision of specialized care based on standards of efficiency and hospital quality, nursing actions are largely implicit in the care of patients with AMI from arrival at the coronary care unit, by identifying absolute and relative signs and symptoms and contraindications to thrombolytic treatment, performing an electrocardiogram for diagnosis, monitoring the patient, channeling a peripheral line, taking vital signs, pain relief, and the preparation and administration of the fibrinolytic, the speed in its administration is the key for it to have greater effectiveness that in many cases are decisive to achieve satisfaction in the services (Nonogi, 2019).

Significance of the problem to Nursing

Currently, the quality of nursing care is a crucial factor to participate in the disciplinary exploration of quality and risk-free health care practices, thus providing the interaction of nursing care with the patient, ensuring that the care is optimal and holistic.

In this regard, Nursing care in Coronary Units to patients with myocardial infarction is based on the clinical assessment of nursing by human response patterns for which they require their scientific foundations, crystallized in the nursing process, which guides in a planned way, systematized and organized of its actions identifies the actual and potential health problems that allow decision-making based on the knowledge and existing evidence about nursing care to be applied in a systematic and organized way of Clinical Nursing Practice, to provide nursing care in a timely and effective manner, which allows reducing hospital readmissions and optimizing institutional resources (Nonogi¸2019).

The physical assessment carried out by the nursing professional, in their own and derived functions, begins with the pain assistance, which should assess the type of pain, location, duration and cause that triggers it, the meaning of the pain for the patient, and the result of the emotional response are essential factors for the nurse to assist him, the fear and anxiety produced by the pain can increase work and heart rate by sympathetic stimulation (Mohammed et.al, 2020)..

In this regard, the perspective of the search for the quality of nursing care in the coronary unit is becoming increasingly important given that said personnel are the ones who receive these patients; therefore, they must have the knowledge and high-level preparation to guide properly timely all their efforts, not only to provide specific treatment to the person with a heart attack but also towards the prevention and early detection of complications.

Purpose of the Research

Considering the focus of the study, the purpose of the research is to publicize the attention and quality of care that the nurses of the coronary unit provide to patients with myocardial infarction in our reality, to design strategies and develop programs strengthening highly specialized care and humanistic practice calling for the nursing professional to reflect to carry out work that provides patient satisfaction as an indicator of quality.

Research Questions

Is there a relationship between nursing care and the quality of care provided to patients with myocardial infarction in the coronary unit?