SUCCESS OF AUDIT IN REDUCING THE TIME TAKEN TO ADMINISTER THROMBOLYSIS AND ASPIRIN IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION

We assessed whether audit might reduce the time taken to give thrombol ysis and aspirin in patients with acute myocardial infarction (N = 116 ). A retrospective analysis was performed of the sources of delay in g iving the drugs (N-60) and the data were presented to clinical staff a ccompanied by guidelines aimed at eliminating delays. A prospective su rvey was undertaken (N = 56) after these interventions. Audit resulted in an overall 31% reduction (P = 0.013) in the time to administer thr ombolysis (median 55 minutes [range 21-1418] v 38 [15-155]): there was a 57% fall (P < 0.0001) in the time to record an electrocardiogram (1 4 minutes [4-34] v 6 [1-19]) and a 33% decrease (P = 0.047) in the tim e 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 ad minister thrombolysis and aspirin to patients admitted with acute myoc ardial infarction can be reduced by audit.