2.50
Hdl Handle:
http://hdl.handle.net/10755/156970
Category:
Abstract
Type:
Presentation
Title:
Improving Door to Balloon Time for STEMI Patients with a Cardiac Alert Program
Author(s):
Cross, Candy C.; Zimmer, Alisha; Tinguely, Sara
Author Details:
Candy C. Cross, RN,BSN,CCRN,CRN, Banner Heart Hospital, Mesa, Arizona, USA, email: candycross@cox.net; Alisha Zimmer; Sara Tinguely
Abstract:
PURPOSE: In 2006 the American College of Cardiology and the American Heart Association challenged hospitals to set a goal to reduce door-to-balloon time to less than 90 minutes. Achieving this goal will directly improve patient outcomes by decreasing infarct size, reducing heart damage, and decreasing mortality. After 8 months of collaboration with the Arizona Department of Health Services and the emergency medical services (EMS), Banner Heart Hospital (BHH) developed a Cardiac Alert program. This program includes an outreach plan that provides advanced care to rural areas of Arizona. DESCRIPTION: When a patient experiencing chest pain activates EMS in the community, the process of identifying a ST-segment elevation myocardial infarction (STEMI) is critical. BHH partnered with the Department of Health and EMS in the surrounding communities to assist with training paramedics to perform 12-lead electrocardiograms (ECGs) in the community and to recognize a STEMI. If ST-segment elevation is present, the ECG is faxed to the emergency department and a phone call is placed to the emergency department physician for confirmation. Once STEMI has been confirmed, the next call is to BHH's Acute Cardiac Transfer/Acceptance line. Important patient information is relayed and a Cardiac Alert (including estimated time of arrival) is announced over the hospital's intercom. This announcement activates admitting to start the registration process and the catheterization laboratory (cath lab) personnel to prepare for the patientÆs arrival. On arrival, a team from the cath lab is waiting and the patient is taken directly to the cath lab. Initiation of this process while the patient is still en-route shortens door-to-balloon time and helps ensure STEMI patients receive treatment within the national standard of less than 90 minutes. EVALUATION/OUTCOMES: BHH's Quality Management team monitors door-to-balloon time on every STEMI patient and reports to the hospital's Initiative Team on a quarterly basis. Information is reviewed and outliers (outside the 90-minute window) are evaluated for the cause and the team works on solutions to improve the outcomes. Data obtained before and after program implementation showed a shortened door-to-balloon time consistently below the national standard. Before the development of the cardiac alert program, less than half (35%) of the STEMI patients presenting to BHH met the national standard. The cardiac alert program was implemented in January 2008. For that year, 97% of STEMI patients coming to BHH via EMS attained a door-to-balloon time of less than 90 minutes. Preliminary data for the first half of 2009 reveal even greater improvements.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleImproving Door to Balloon Time for STEMI Patients with a Cardiac Alert Programen_GB
dc.contributor.authorCross, Candy C.en_GB
dc.contributor.authorZimmer, Alishaen_GB
dc.contributor.authorTinguely, Saraen_GB
dc.author.detailsCandy C. Cross, RN,BSN,CCRN,CRN, Banner Heart Hospital, Mesa, Arizona, USA, email: candycross@cox.net; Alisha Zimmer; Sara Tinguelyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156970-
dc.description.abstractPURPOSE: In 2006 the American College of Cardiology and the American Heart Association challenged hospitals to set a goal to reduce door-to-balloon time to less than 90 minutes. Achieving this goal will directly improve patient outcomes by decreasing infarct size, reducing heart damage, and decreasing mortality. After 8 months of collaboration with the Arizona Department of Health Services and the emergency medical services (EMS), Banner Heart Hospital (BHH) developed a Cardiac Alert program. This program includes an outreach plan that provides advanced care to rural areas of Arizona. DESCRIPTION: When a patient experiencing chest pain activates EMS in the community, the process of identifying a ST-segment elevation myocardial infarction (STEMI) is critical. BHH partnered with the Department of Health and EMS in the surrounding communities to assist with training paramedics to perform 12-lead electrocardiograms (ECGs) in the community and to recognize a STEMI. If ST-segment elevation is present, the ECG is faxed to the emergency department and a phone call is placed to the emergency department physician for confirmation. Once STEMI has been confirmed, the next call is to BHH's Acute Cardiac Transfer/Acceptance line. Important patient information is relayed and a Cardiac Alert (including estimated time of arrival) is announced over the hospital's intercom. This announcement activates admitting to start the registration process and the catheterization laboratory (cath lab) personnel to prepare for the patientÆs arrival. On arrival, a team from the cath lab is waiting and the patient is taken directly to the cath lab. Initiation of this process while the patient is still en-route shortens door-to-balloon time and helps ensure STEMI patients receive treatment within the national standard of less than 90 minutes. EVALUATION/OUTCOMES: BHH's Quality Management team monitors door-to-balloon time on every STEMI patient and reports to the hospital's Initiative Team on a quarterly basis. Information is reviewed and outliers (outside the 90-minute window) are evaluated for the cause and the team works on solutions to improve the outcomes. Data obtained before and after program implementation showed a shortened door-to-balloon time consistently below the national standard. Before the development of the cardiac alert program, less than half (35%) of the STEMI patients presenting to BHH met the national standard. The cardiac alert program was implemented in January 2008. For that year, 97% of STEMI patients coming to BHH via EMS attained a door-to-balloon time of less than 90 minutes. Preliminary data for the first half of 2009 reveal even greater improvements.en_GB
dc.date.available2011-10-26T19:18:19Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:18:19Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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