IMPLICATION FOR PRACTICE
Results of this study corroborate those of other investigators in regard
to reducing D2B time by achieving STEMI activation in the field as
opposed to in the ED. Further, our recommendation to collaborate with
EMS personnel to accomplish these outcomes is supported by findings from
a study reported by a group of physicians and nurses in South
Carolina.31 These investigators were able to
significantly lower D2B times by empowering EMS providers to activate
the CCL prior to reaching the hospital. By so doing, there were able to
reduce their baseline D2B time from 52.5 minutes in 2011 to sustained
D2B times under 40 minutes over the next four consecutive years.
Results from this study also emphasize the need for STEMI coordinators
to diligently promote precise documentation of STEMI logs to identify
potential problem areas in the implementation of STEMI guidelines. They
need to look for non-patient-related barriers that may impact D2B times
in their respective clinical sites and explore options for removing
these barriers to promote timely care of these patients. Documentation
of socioeconomic status on STEMI logs would be helpful in clarifying how
this variable may contribute to treatment delays.