2.50
Hdl Handle:
http://hdl.handle.net/10755/162476
Type:
Presentation
Title:
Designated EKG Stretchers: Help or Hindrance?
Abstract:
Designated EKG Stretchers: Help or Hindrance?
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Lazarus, John, RN
P.I. Institution Name:William Beaumont Hospital-Troy
Title:Administrative Nurse Manager
Contact Address:44201 Dequindre, Troy, MI, 48085, USA
Contact Telephone:248-964-6034
Co-Authors:Christine C. McEachin, BSN, CEN, MBA, Paramedic/IC
[Clinical Poster] Clinical Topic: The American Heart Association (AHA) recommends the time for Door-to-Electrocardiogram (EKG) for Emergency Center (EC) patients meeting rapid EKG criteria to be <10 minutes. Emergency Centers across America have noticed an increase in patient volumes and acuity. This has lead to overcrowding and a lack of success meeting the AHA EKG expectation. The purpose of this project was to identify a simple, easy to implement process to meet the guideline.

Implementation: The 346 bed community hospital located in Southeastern Michigan has an annual EC volume of 69,000. In December 2006, members of a multidisciplinary task force in the institution identified that the AHA EKG guideline was not consistently being met. Thorough review identified two primary factors: 1) No consistent process was in place for EKG completion. 2) A specific location for acquisition of the EKG was not identified.

The proposed solution was simple. A designated stretcher and area for completion of EKG's was determined. Patients meeting Rapid EKG criteria would be assisted to the stretcher and the EC Triage Registered Nurse (RN) would page the EKG Technician. The EKG Technician would report to the EKG Stretcher, complete an EKG and have the EC physician immediately review it for appropriate patient placement and intervention. All EC clinical staff was then educated on the proposed process.

Outcomes: Prior to the implementation of the EKG Stretcher process, door-to-EKG times were 19 minutes (12/06). January 2007, the process was implemented with a decrease in time to 13 minutes. Throughout Q1-2007 door-to-EKG times remained <10 minutes. Q2 data demonstrated an increase to 11 minutes with Q3 data pending. The increase in door-to-EKG time has been correlated to higher EC volume and the presence of only one EKG Technician during the midnight shift. Although there is adequate evidence to demonstrate that a designated EKG stretcher decreases door-to-EKG time, further strategies may need to be identified during high volume times to consistently meet the AHA standard.

Recommendations: Meeting the AHA door-to-EKG standard can be difficult when EC resources and space is limited. Evidence reveals early identification of ST Elevation Myocardial Infarction (STEMI) through rapid EKG acquisition improves door-to-intervention time and patient outcome. Quality care remains fundamental to EC practice. Frequent multidisciplinary review of the door-to-EKG process, with uncomplicated changes when necessary provides the opportunity for the best possible patient outcome.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDesignated EKG Stretchers: Help or Hindrance?en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162476-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Designated EKG Stretchers: Help or Hindrance?</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lazarus, John, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">William Beaumont Hospital-Troy</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Administrative Nurse Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">44201 Dequindre, Troy, MI, 48085, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">248-964-6034</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">aubnuk@yahoo.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Christine C. McEachin, BSN, CEN, MBA, Paramedic/IC</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: The American Heart Association (AHA) recommends the time for Door-to-Electrocardiogram (EKG) for Emergency Center (EC) patients meeting rapid EKG criteria to be &lt;10 minutes. Emergency Centers across America have noticed an increase in patient volumes and acuity. This has lead to overcrowding and a lack of success meeting the AHA EKG expectation. The purpose of this project was to identify a simple, easy to implement process to meet the guideline. <br/><br/>Implementation: The 346 bed community hospital located in Southeastern Michigan has an annual EC volume of 69,000. In December 2006, members of a multidisciplinary task force in the institution identified that the AHA EKG guideline was not consistently being met. Thorough review identified two primary factors: 1) No consistent process was in place for EKG completion. 2) A specific location for acquisition of the EKG was not identified. <br/><br/>The proposed solution was simple. A designated stretcher and area for completion of EKG's was determined. Patients meeting Rapid EKG criteria would be assisted to the stretcher and the EC Triage Registered Nurse (RN) would page the EKG Technician. The EKG Technician would report to the EKG Stretcher, complete an EKG and have the EC physician immediately review it for appropriate patient placement and intervention. All EC clinical staff was then educated on the proposed process. <br/><br/>Outcomes: Prior to the implementation of the EKG Stretcher process, door-to-EKG times were 19 minutes (12/06). January 2007, the process was implemented with a decrease in time to 13 minutes. Throughout Q1-2007 door-to-EKG times remained &lt;10 minutes. Q2 data demonstrated an increase to 11 minutes with Q3 data pending. The increase in door-to-EKG time has been correlated to higher EC volume and the presence of only one EKG Technician during the midnight shift. Although there is adequate evidence to demonstrate that a designated EKG stretcher decreases door-to-EKG time, further strategies may need to be identified during high volume times to consistently meet the AHA standard. <br/><br/>Recommendations: Meeting the AHA door-to-EKG standard can be difficult when EC resources and space is limited. Evidence reveals early identification of ST Elevation Myocardial Infarction (STEMI) through rapid EKG acquisition improves door-to-intervention time and patient outcome. Quality care remains fundamental to EC practice. Frequent multidisciplinary review of the door-to-EKG process, with uncomplicated changes when necessary provides the opportunity for the best possible patient outcome. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:51Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:51Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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