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 thrombolysis and aspirin in patients 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.