Abstract
We assessed whether audit might reduce the time taken to give thrombolysis and aspirin inpatients with acute myocardial infarction (N=116). A retrospective analysis was performed of the sources of delay in giving the drugs (N-60) and the data were presented to clinical staff accompanied by guidelines aimed at eliminating delays. A prospective survey was undertaken (N=56) after these interventions. Audit resulted in an overall 31% reduction (P=0.013) in the time to administer thrombolysis (median 55 minutes [range 21–148] v 38 [15–155]): there was a 57% fall (P<0.0001) in the time to record an electrocardiogram (14 minutes [4–34] v 6 [1–19]) and a 33% decrease (P=0.047) in the time taken to begin thrombolysis in the coronary care unit (15 minutes [0–110) v 10 [5–70]). The time taken to give aspirin was also reduced (P=0.001) from 58 minutes (15–400) to 15 (3–235). The time taken to administer thrombolysis and aspirin to patients admitted with acute myocardial infarction can be reduced by audit.
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