Improving Clinical Decision Making for Acute Myocardial Infarction
Research type
Research Study
Full title
Feasibility study to develop a tool to improve clinical decision-making in the primary percutaneous intervention (pPCI) pathway
IRAS ID
251710
Contact name
Victoria McGilligan
Contact email
Sponsor organisation
Ulster University
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
When a paramedic is called out to a patient with a suspected heart attack (more accurately known as Acute Myocardial Infarction or AMI), they will carry out an Electrocardiogram (ECG) and decide whether or not to bring that person straight to a specialist hospital site to receive emergency treatment. The reading of an ECG is difficult and complex and often the task is passed to a nurse specialist called the ‘nurse activator’ in the coronary care unit. If the nurse cannot make a confident decision, the ECG will be passed to a cardiologist to make the final call. If accepted, the nurse will refer this patient to an emergency clinical care pathway, called the Primary Percutaneous Intervention (pPCI) pathway, to deliver the emergency treatment the patient requires. False activations of this pathway are common since the staff tend to be precautious given the life threatening repercussions. This can have major implications for the patient and results in a strain on resources for the health service.
Patients referred or ‘accepted’ for pPCI often come from different demographic groups, have variable symptoms and have referrals made at different times during the day or night. Analysing such factors and comparing them with the patients outcome may be useful in developing a clinical decision making tool to help improve clinical decision-making for pPCI referals. This data, which is routinely recorded by nurse activators, has been comprehensively collated into a clinical dataset called the pPCI dataset, held at Altnagelvin Hospital in the Western Health and Social Care Trust. The aim of this proposed feasibility study is to analyse this data to identify the relationships within the data and compare these with patient outcomes. This will allow us to identify the important parts of the dataset to use in the future development of clinical decision making tools to support cardiology staff in diagnosing and managing emergency heart attacks.REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
18/LO/2203
Date of REC Opinion
20 Dec 2018
REC opinion
Favourable Opinion