2.50
Hdl Handle:
http://hdl.handle.net/10755/164204
Category:
Abstract
Type:
Presentation
Title:
Achieving Excellence In Cardiac Outcomes
Author(s):
Jensen, Kathy
Author Details:
Kathy Jensen, MSN, RN, CCNS, APRN, BC, Shawnee Mission Regional Cardiac and Vascular Center, Shawnee Mission, Kansas, USA, email: nacnsorg@nacns.org
Abstract:
Purpose: To consistently implement the American Heart Association's Purpose: This inquiry explores the under-utilization of evidence-based skin care standing orders and attempts to address target etiologies to achieve the expected outcome of immediate, consistent treatment by the bedside RN. Significance: Over 1 million people develop pressure ulcers yearly with treatment costing the United States healthcare system approximately $2.2 to $3.6 billion (Ratliff & Bryant, 2003). Pressure ulcer prevalence is currently estimated at 3.5%-29.5% in hospitals on any given day (Hiser, et al., 2006). Pressure ulcers cause pain and suffering and can increase length of stay (Brem & Lyder, 2004). Many pressure ulcers can be prevented and treated utilizing nursing measures. Background/Design: Two clinical nurse specialists (CNS) developed a set of evidence-based nursing skin care standing orders to allow the registered nurse (RN) to treat non-disease based skin problems resulting from pressure, friction, shear and moisture. The expected outcome of a decrease in the amount of time from onset "Get With The Guidelines-CAD Program" through interdisciplinary process improvement initiatives. To optimize clinical outcomes for acute MI patients through improved compliance with evidence based national guidelines for secondary prevention of coronary heart disease. Significance: American Heart Association (AHA) projections have shown that implementation of cardiovascular disease secondary prevention guidelines nationwide as promoted by AHA's "Get With The Guidelines: CAD Program" could result is saving more than 80,000 lives each year. Background/Design: Quality measures monitored and addressed were: 1) ASA, Beta Blocker, Ace Inhibitor, and lipid lowering therapy prescribed at discharge and 2) Smoking Cessation counseling/literature provided prior to discharge. Methods: The target population of this initiative was all STEMI and NSTEMI patients admitted to the Shawnee Mission Regional Cardiac and Vascular Center between 3rdQ 2004 and 2ndQ 2005. Following baseline assessment of performance multifaceted opportunities for improvement were identified and implemented by an interdisciplinary team facilitated by the CV CNS. Keys to success were interdisciplinary involvement, education and consistent feedback to key stakeholders, development of user friendly tools to support the process, blinded individual physician reports, and administrative expectation of superior performance. Findings: Greater than 85% of compliance with each of the 5 indicators was achieved for 4 consecutive quarters (ASA 100%, Beta Blocker 100%, ACE/ARB 99%, Statins 94%, Smoking Cessation Counseling 96%). During this time period AMI mortality was reduced from 10% to 5.6%. The Outcome Sciences Opportunity for Lives Saved calculator noted a significant decrease in predicted composite repeat CAD events (1st and 2ndQ 2004 - 2.89 CAD events, 3rd and 4thQ 2004 - 0.58 CAD events. 1st and 2ndQ 2005 - 0.72 CAD events) during this time period. Conclusions: As a result of improved compliance with evidence based guidelines mortality was decreased, clinical outcomes were improved, and the Shawnee Mission Regional Cardiac and Vascular Center was awarded the Get With the Guidelines-CAD Annual Performance Award at the 2005 AHA Scientific Sessions in Dallas, Texas. Implications for Practice: Compliance with national evidence based secondary CAD prevention guidelines saves lives.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
CNS Outcomes: Ensuring Safety and Quality
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Phoenix, Arizona, USA
Description:
Conference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, 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_US
dc.typePresentationen_GB
dc.titleAchieving Excellence In Cardiac Outcomesen_GB
dc.contributor.authorJensen, Kathyen_US
dc.author.detailsKathy Jensen, MSN, RN, CCNS, APRN, BC, Shawnee Mission Regional Cardiac and Vascular Center, Shawnee Mission, Kansas, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164204-
dc.description.abstractPurpose: To consistently implement the American Heart Association's Purpose: This inquiry explores the under-utilization of evidence-based skin care standing orders and attempts to address target etiologies to achieve the expected outcome of immediate, consistent treatment by the bedside RN. Significance: Over 1 million people develop pressure ulcers yearly with treatment costing the United States healthcare system approximately $2.2 to $3.6 billion (Ratliff & Bryant, 2003). Pressure ulcer prevalence is currently estimated at 3.5%-29.5% in hospitals on any given day (Hiser, et al., 2006). Pressure ulcers cause pain and suffering and can increase length of stay (Brem & Lyder, 2004). Many pressure ulcers can be prevented and treated utilizing nursing measures. Background/Design: Two clinical nurse specialists (CNS) developed a set of evidence-based nursing skin care standing orders to allow the registered nurse (RN) to treat non-disease based skin problems resulting from pressure, friction, shear and moisture. The expected outcome of a decrease in the amount of time from onset "Get With The Guidelines-CAD Program" through interdisciplinary process improvement initiatives. To optimize clinical outcomes for acute MI patients through improved compliance with evidence based national guidelines for secondary prevention of coronary heart disease. Significance: American Heart Association (AHA) projections have shown that implementation of cardiovascular disease secondary prevention guidelines nationwide as promoted by AHA's "Get With The Guidelines: CAD Program" could result is saving more than 80,000 lives each year. Background/Design: Quality measures monitored and addressed were: 1) ASA, Beta Blocker, Ace Inhibitor, and lipid lowering therapy prescribed at discharge and 2) Smoking Cessation counseling/literature provided prior to discharge. Methods: The target population of this initiative was all STEMI and NSTEMI patients admitted to the Shawnee Mission Regional Cardiac and Vascular Center between 3rdQ 2004 and 2ndQ 2005. Following baseline assessment of performance multifaceted opportunities for improvement were identified and implemented by an interdisciplinary team facilitated by the CV CNS. Keys to success were interdisciplinary involvement, education and consistent feedback to key stakeholders, development of user friendly tools to support the process, blinded individual physician reports, and administrative expectation of superior performance. Findings: Greater than 85% of compliance with each of the 5 indicators was achieved for 4 consecutive quarters (ASA 100%, Beta Blocker 100%, ACE/ARB 99%, Statins 94%, Smoking Cessation Counseling 96%). During this time period AMI mortality was reduced from 10% to 5.6%. The Outcome Sciences Opportunity for Lives Saved calculator noted a significant decrease in predicted composite repeat CAD events (1st and 2ndQ 2004 - 2.89 CAD events, 3rd and 4thQ 2004 - 0.58 CAD events. 1st and 2ndQ 2005 - 0.72 CAD events) during this time period. Conclusions: As a result of improved compliance with evidence based guidelines mortality was decreased, clinical outcomes were improved, and the Shawnee Mission Regional Cardiac and Vascular Center was awarded the Get With the Guidelines-CAD Annual Performance Award at the 2005 AHA Scientific Sessions in Dallas, Texas. Implications for Practice: Compliance with national evidence based secondary CAD prevention guidelines saves lives.en_GB
dc.date.available2011-10-27T11:43:58Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:43:58Z-
dc.conference.date2007en_US
dc.conference.nameCNS Outcomes: Ensuring Safety and Qualityen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPhoenix, Arizona, USAen_US
dc.descriptionConference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USAen_US
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.en_US
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