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

Abstract

Introduction & Aim: This study aimed to develop a standard of clinical guidelines for dealing with patients with acute chest pain in the emergency department at Al-Zahra Hospital in Isfahan. Methods: In the first phase, a comprehensive approach and guidelines for patients with unstable angina referred to the emergency department, according to experts from the heart and emergency medicine and using valid sources was developed. In the second phase, the guidelines ere evaluated in a clinical trial. In this trial, 100 patients were randomly assigned into intervention and control groups. The waiting time for the first visit, paraclinical measures, appropriate treatment; the physician's satisfaction with treatment, the patient's admission to the emergency room, number of visits and treatment outcome; the patient's satisfaction from emergency services and treatment outcome were compared between two groups. Results: The mean of patients waiting time to receive the first visit, paraclinical measures, and appropriate treatment in the intervention group were significantly lower than the control group (P-value<0.05). The mean of physician's satisfaction score from the treatment process, patient's admission to the emergency room, number of visits and outcome of treatment in the intervention group was significantly higher than the control group (P-value<0.05). The mean patient satisfaction score from the emergency services in the intervention group was significantly higher than the control group (P-value=0.0001). Conclusions: The developed guidelines for dealing with patients with acute chest pain in the emergency room significantly reduce the patient's waiting time in receiving care and improve the satisfaction of the physicians and the patients.