Abstract of Dissertation

Keyword : Therapeutic Management; Acute Myocardial Infarction; JCI Guidelines

Objective : To assess the existing clinical management of acute myocardial infarction as per JCI norms. To find the gaps and give suggestion to remove the noncompliance in the path of JCI accreditation for the management of Acute Myocardial infarction cases.

Background : Acute myocardial infarction (AMI) condition occurs when blood flow to the heart is abruptly cut off because of narrowing of blood vessel, causing tissue damage. This usually occurs by blockage in one or more of the coronary arteries. Prevalence of AMI is high in urban areas of Tamil Nadu and Kerala where it ranges between 11 to 13%, followed by Delhi, Uttar Pradesh, Jammu, Punjab and, Rajasthan where it ranges between 6-10%. Similarly, it is high in rural areas of Kerala and Jammu & Kashmir, where it ranges between 6-7%. JCI norms can be used to assess the existing clinical management of acute myocardial infarction and helps in improving according to JCI norms.

Methodology : The study design was Retrospective study and data is captured for entire year 2015. The data was collected through record files with the sample size of 108 patients.

Findings : Results of the study suggested that aspirin was provided to almost all the patients during admission and discharge process as required in JCI norms. The main gap was in Beta-Blockers where at least 40% of the cases were not receiving the medication which is necessary as guided in JCI norms. Secondly, there was no record of smoking cessation counseling given to the patients with acute myocardial infarction.

Recommendations : JCI norms are important for international accreditation of the hospitals. Assessing the facility and removing the non-compliance can help in getting the accreditation done. As in the above study, prescribing Beta-Blockers at discharge and counseling for smoking cessation to the acute myocardial infarction patients can reduce the incidence of infarction and its related complications. This can also reduce the rate of re-infarction cases, thus helping the hospital to be JCI accredited.