EXCELLENT SERVICE EMERGENCY NURSING CARE MANAGEMENT FOR MRS. R WITH STEMI

Abstract

Background: Cardiovascular disease remains the leading cause of death globally, with ST-Elevation Myocardial Infarction (STEMI) representing the most serious acute coronary syndrome that requires immediate intervention. To meet Sustainable Development Goals (SDGs) Target 3, emergency nursing care must incorporate excellent service principles to optimize clinical outcomes and lower premature mortality. Objectives: This study aimed to develop, implement, and evaluate an excellent service-based emergency nursing care management for a patient presenting with STEMI at the CVCU ward of RSUP H. Adam Malik Medan. Methods: A clinical case study approach was utilized to manage Mrs. R, a 54-year-old female with STEMI and a history of Diabetes Mellitus. Comprehensive nursing management spanning three days included rapid assessment, formulation of Indonesian Nursing Diagnoses (SDKI), application of Indonesian Nursing Interventions (SIKI), implementation, and evaluation. Results: Three primary nursing diagnoses were identified: decreased cardiac output, acute pain, and impaired gas exchange. Following three days of customized, patient-centered interventions—including intensive hemodynamic monitoring, semi-Fowler positioning, titrated oxygen therapy, and non-pharmacological pain relief—the patient showed progressive improvement. Chest pain intensity decreased from a scale of 5 to 3, respiratory distress subsided, and blood gas metrics stabilized. Conclusions: The systematic integration of excellent service nursing protocols significantly improves hemodynamic stability and pain management in acute STEMI patients, thereby contributing directly to reduced cardiovascular mortality.