Cardiac Swarm: Team Concept for Rapid Identification and Treatment of Acute Coronary Syndrome Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/162691
Type:
Presentation
Title:
Cardiac Swarm: Team Concept for Rapid Identification and Treatment of Acute Coronary Syndrome Patients
Abstract:
Cardiac Swarm: Team Concept for Rapid Identification and Treatment of Acute Coronary Syndrome Patients
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:England, Mary Ann, RN, BS, EMT
P.I. Institution Name:Exempla Saint Joseph Hospital
Title:Clinical Educator Emergency Department
Contact Address:, Denver, CO, 80218-, USA
Contact Telephone:(303) 318-3372
Co-Authors:S. Adam Hill, MD
Purpose: To use a multidisciplinary approach for the early identification and treatment of cardiac patients who present to the Emergency Department (ED) with signs and symptoms of Acute Coronary Syndrome (ACS).

Design: Internal process improvement initiative to expedite the recognition and treatment of Acute Coronary Syndrome patients.

Setting: A community teaching hospital in a western state with a 32 acute bed Emergency Department and 11 bed observation unit. Emergency Department has 49,000 visits per year.

Participation/Subjects: All patients who present to the Emergency Department with signs and symptoms of Acute Coronary Syndrome.

Methods: A flow diagram was conducted mapping the process for a cardiac patient who presented to the ED with signs and symptoms of ACS. The Nurse-Physician champions of the project created an algorithm that identified signs and symptoms of typical and atypical chest pain. A cardiac swarm was called for any patient who met ACS criteria. The cardiac swarm consisted of an overhead page that alerted staff to a possible ACS patient, the patient was met in the room by a nurse, physician, and emergency room technician. The team performed a rapid EKG while the patient is placed on a monitor with O2 and IV access is obtained with lab draw. Along with history, a clinical decision is made regarding ACS as diagnosis. Acuity then is assigned depending on clinical data i.e. STEMI, NSTEMI, Angina. Pre and post cardiac swarm data was obtained concurrently by documentation of time to initial EKG and EKG to physician.

Results: The goal was to have an initial EKG to MD in less than ten minutes from arrival. Prior to implementing the cardiac swarm compliance with door to EKG to physician was variable. After implementation, compliance increased to 50% in the first month. The multidisciplinary approach was a key factor in obtaining decreased door to treatment times and chest pain center accreditation.

Recommendations: Standardized protocols and practices specifically designed to aid staff in early recognition and treatment of typical and atypical ACS patients promotes critical thinking and consistent practice. Engage the staff by providing them with continual education and feedback on patient outcomes.
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.titleCardiac Swarm: Team Concept for Rapid Identification and Treatment of Acute Coronary Syndrome Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162691-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Cardiac Swarm: Team Concept for Rapid Identification and Treatment of Acute Coronary Syndrome Patients</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">England, Mary Ann, RN, BS, EMT</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Exempla Saint Joseph Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Educator Emergency Department</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Denver, CO, 80218-, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(303) 318-3372</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">englandm@exempla.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">S. Adam Hill, MD</td></tr><tr><td colspan="2" class="item-abstract">Purpose: To use a multidisciplinary approach for the early identification and treatment of cardiac patients who present to the Emergency Department (ED) with signs and symptoms of Acute Coronary Syndrome (ACS). <br/><br/>Design: Internal process improvement initiative to expedite the recognition and treatment of Acute Coronary Syndrome patients. <br/><br/>Setting: A community teaching hospital in a western state with a 32 acute bed Emergency Department and 11 bed observation unit. Emergency Department has 49,000 visits per year. <br/><br/>Participation/Subjects: All patients who present to the Emergency Department with signs and symptoms of Acute Coronary Syndrome. <br/><br/>Methods: A flow diagram was conducted mapping the process for a cardiac patient who presented to the ED with signs and symptoms of ACS. The Nurse-Physician champions of the project created an algorithm that identified signs and symptoms of typical and atypical chest pain. A cardiac swarm was called for any patient who met ACS criteria. The cardiac swarm consisted of an overhead page that alerted staff to a possible ACS patient, the patient was met in the room by a nurse, physician, and emergency room technician. The team performed a rapid EKG while the patient is placed on a monitor with O2 and IV access is obtained with lab draw. Along with history, a clinical decision is made regarding ACS as diagnosis. Acuity then is assigned depending on clinical data i.e. STEMI, NSTEMI, Angina. Pre and post cardiac swarm data was obtained concurrently by documentation of time to initial EKG and EKG to physician.<br/><br/>Results: The goal was to have an initial EKG to MD in less than ten minutes from arrival. Prior to implementing the cardiac swarm compliance with door to EKG to physician was variable. After implementation, compliance increased to 50% in the first month. The multidisciplinary approach was a key factor in obtaining decreased door to treatment times and chest pain center accreditation. <br/><br/>Recommendations: Standardized protocols and practices specifically designed to aid staff in early recognition and treatment of typical and atypical ACS patients promotes critical thinking and consistent practice. Engage the staff by providing them with continual education and feedback on patient outcomes.</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:31Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:31Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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