Abstract:

Objective To apply the best evidence on volume management of myocardial infarction patients during the acute phase to clinical practice and evaluate its effect. Methods The team summarized the best evidence for volume management in patients with acute myocardial infarction，developed evaluation indicators based on the best evidence，analyzed the influencing factors of evidence translation，and developed implementation plans in combination with clinical scenarios. Evidence based clinical practice was implemented from September 2023 to December 2023 in cardiovascular wards of two campuses of a tertiary class A hospital in Chongqing. The knowledge level of medical staff on volume management of acute myocardial infarction patients and the implementation rate of review indicators were compared before and after the practice，as well as the improvement of patient related outcome indicators. Results Before and after the application of evidence，the nurses’ volume management knowledge score improved from （80.13±11.97） to （89.37±14.91）（P<0.001），and the implementation rate of the 11 review indicators improved from 15.38%-57.69% to 66.67%-100%（P<0.05）. Patients’ NYHA cardiac function grade，number of pulmonary B-lines，left ventricular ejection fraction，NT-proBNP，maximum diameter of inferior vena cava，length of hospital stay，and unplanned readmission rate within 3 months improved（P<0.05），while six-minute walking distance did not improve（P>0.05）. Conclusion Applying an evidence-based program for volume management in the acute phase of myocardial infarction patients improves patient prognosis and increases nurses’ adherence to best evidence implementation.

Key words: Myocardial Infarction, Volume Management, Lung Ultrasound, Evidence-Based Practice, Quality of Care