Influence of Chest Pain Evaluation Program on Early Thrombolysis of Acute Myocardial Infarction Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/162824
Type:
Presentation
Title:
Influence of Chest Pain Evaluation Program on Early Thrombolysis of Acute Myocardial Infarction Patients
Abstract:
Influence of Chest Pain Evaluation Program on Early Thrombolysis of Acute Myocardial Infarction Patients
Conference Sponsor:Emergency Nurses Association
Conference Year:1996
Author:Cosico, Joseph, RN, MA, CCRN
P.I. Institution Name:Montefiore Medical Center
Contact Address:Albert Einstein College of Medicine, Departments of Nursing, Medicine & Emergency Medicine
Co-Authors:L. Kunkel, S. McAllen, K. Hemmingway, M. Menegus, R. Wharton, M. Goldberger, H. Mueller, and M. Salomon
Early thrombolysis has increased survival of eligible patients with acute myocardial infarction (AMI). Therefore, early triage and shorter Time to Thrombolysis (TTT, time of patient arrival in the Emergency Department (ED) to time of thrombolysis) are high priorities in delivering emergency care. In a high volume tertiary care center (>500 beds), prompt attention to AMI patients can be delayed.

A Chest Pain Evaluation Program (CPEP) was developed in collaboration with the Emergency Department and Division of Cardiology. The following steps were taken: 1) Systematic education of ED nursing and medical personnel on managing AMI patients; 2) Development of an algorithm which includes fast-track triage, an electrocardiogram with 10 minutes of ED arrival, and an in-hospital ô911ö page system, to provide immediate cardiology service, among others; and 3) Quality improvement review of each patient who received thrombolysis by both ED and cardiology.

Outcomes: (Information was re-formatted for this posting.)
TTT data, prospectively collected before and after the implementation of the CPEP, are presented in 3 groups (GR). Pre-CPEP---------CPEP--------------------------------------------------------------------GR 1-------------------GR 2 -------------GR 3-----------------------------------------------Study Period------ 7/93-7/94------------- 8/94-3/95------- 3/95-11/95---------------------------------------N--------------------- 45 -----------------------36 --------------------36-------------------------------------------Median (minutes)----71----------------------- 57------------------- 40-----------------------------------------Range (minutes)------31-221 ----------- 21-116 -------------- 15-136--------------------------------------------------Two-Tailed------P* --------------- <0.03----------------- <0.01------------------------------------[*Mann-Whitney U Test] In this series of patients, the TTT was significantly reduced. We achieved this without adding new personnel and changing the physical plant of the ED, thus, it was cost-effective. Therefore, we recommend the development of a CPEP, as indicated above, to favorably impact survival from AMI. [Clinical Poster Presentation]
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.titleInfluence of Chest Pain Evaluation Program on Early Thrombolysis of Acute Myocardial Infarction Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162824-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Influence of Chest Pain Evaluation Program on Early Thrombolysis of Acute Myocardial Infarction 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">1996</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cosico, Joseph, RN, MA, CCRN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Montefiore Medical Center</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Albert Einstein College of Medicine, Departments of Nursing, Medicine &amp; Emergency Medicine</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">res@ena.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">L. Kunkel, S. McAllen, K. Hemmingway, M. Menegus, R. Wharton, M. Goldberger, H. Mueller, and M. Salomon</td></tr><tr><td colspan="2" class="item-abstract">Early thrombolysis has increased survival of eligible patients with acute myocardial infarction (AMI). Therefore, early triage and shorter Time to Thrombolysis (TTT, time of patient arrival in the Emergency Department (ED) to time of thrombolysis) are high priorities in delivering emergency care. In a high volume tertiary care center (&gt;500 beds), prompt attention to AMI patients can be delayed.<br/><br/>A Chest Pain Evaluation Program (CPEP) was developed in collaboration with the Emergency Department and Division of Cardiology. The following steps were taken: 1) Systematic education of ED nursing and medical personnel on managing AMI patients; 2) Development of an algorithm which includes fast-track triage, an electrocardiogram with 10 minutes of ED arrival, and an in-hospital &ocirc;911&ouml; page system, to provide immediate cardiology service, among others; and 3) Quality improvement review of each patient who received thrombolysis by both ED and cardiology.<br/><br/>Outcomes: (Information was re-formatted for this posting.)<br/>TTT data, prospectively collected before and after the implementation of the CPEP, are presented in 3 groups (GR). Pre-CPEP---------CPEP--------------------------------------------------------------------GR 1-------------------GR 2 -------------GR 3-----------------------------------------------Study Period------ 7/93-7/94------------- 8/94-3/95------- 3/95-11/95---------------------------------------N--------------------- 45 -----------------------36 --------------------36-------------------------------------------Median (minutes)----71----------------------- 57------------------- 40-----------------------------------------Range (minutes)------31-221 ----------- 21-116 -------------- 15-136--------------------------------------------------Two-Tailed------P* --------------- &lt;0.03----------------- &lt;0.01------------------------------------[*Mann-Whitney U Test] In this series of patients, the TTT was significantly reduced. We achieved this without adding new personnel and changing the physical plant of the ED, thus, it was cost-effective. Therefore, we recommend the development of a CPEP, as indicated above, to favorably impact survival from AMI. [Clinical Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:34:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:34:47Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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