Reflections on the process of auditing myocardial infarction.

The publication of the National Service Framework for Coronary Heart Disease has meant that audit is becoming an increasingly important part of cardiac healthcare provision in England. Comparisons between hospitals will be made so it is essential that the audit data is as robust as possible. Nurses often play a key role in the collection of such data. This article reflects on this process, with particular reference to thrombolysis in acute myocardial infarction. Topics discussed include eligibility, the role of a clinician, electrocardiogram interpretation, justified delays, inappropriate and "missed" administration. As some of the information is, arguably, open to interpretation, the authors believe that clinical auditors will inevitably have to grapple with such clinical definitions and their implications.