A Multidisciplinary Approach to Reducing the "Door to Balloon" Time for ST Elevation Acute Myocardial Infarction

2.50
Hdl Handle:
http://hdl.handle.net/10755/183089
Category:
Abstract
Type:
Presentation
Title:
A Multidisciplinary Approach to Reducing the "Door to Balloon" Time for ST Elevation Acute Myocardial Infarction
Author(s):
Miller, George; Lofgren, Jennifer
Author Details:
George Miller, RN, CCRN, CSC, email: george.miller@flaglerhospital.org; Jennifer Lofgren
Abstract:
PURPOSE:
Prompt Percutaneous Coronary Intervention(PCI) for patients with ST Elevation Myocardial Infarction(STEMI) significantly reduces mortality and morbidity. We sought to review and compare the processes, employed at our institution, for minimizing preventable delays in "Door-to-Balloon" time, thus employing evidenced based practice to maximize patient outcome as we implemented American Heart Association(AHA) and American College of Cardiology(ACC) guidelines.

METHOD:
We conducted a qualitative review of patients presenting to the Emergency Department with evolving STEMI. The multidisciplinary team included direct care nurses from the Emergency Department, Cardiac Cath Lab, Cardiovascular Nursing, technologists and physicians. Flagler direct care nurses are key members and facilitators of this multidisciplinary quality improvement team. Data gathering methods included participation in the setting, direct observation, staff interviews, and analysis of documents. The following nurse sensitive indicators, length of stay and cardiac arrest, are presented in relation to the "Door-to-Balloon" core measure for ST Elevation Myocardial Infarction.

FINDINGS:
The data reflects Flagler Hospital's average "Door-to-Balloon" time from January 2007 through June 2008 and indicates continuous improvement as the process was refined. Significantly, this average "Door-to-Balloon" time is below the goal of 90 minutes or less for first quarter 2008 through second quarter 2008. Our mortality rate is 1.7% for Door-to-Balloon in less than 90 minutes (< 90) for STEMI patients for first quarter 2007 through first quarter 2008. This compares very favorably with the National Registry of Myocardial Infarction (NRMI) national benchmark, 3% mortality rate. Also, Flagler Hospital's diagnostic related group data shows a 1.5-day decrease in length of stay for the STEMI patients who did not have a myocardial infarction.

DISCUSSION:
Hospitals can achieve the recommended AHA and ACC guidelines for Door-to-Balloon time with specific process design efforts. The recommended best practices involve extensive interdisciplinary cooperation and collaboration. Following the prescribed steps will result in significant improvement in practice, outcomes and quality.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2009
Conference Name:
6th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Magnet Hospitals of Florida; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Kissimmee, Florida
Description:
6th Annual Florida Magnet Research Conference � Theme: Research at the Point of Care. Held 12-13 February 2009 at Gaylord Palms Resort and Convention Center, Kissimmee, Florida, 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.titleA Multidisciplinary Approach to Reducing the "Door to Balloon" Time for ST Elevation Acute Myocardial Infarctionen_GB
dc.contributor.authorMiller, Georgeen_US
dc.contributor.authorLofgren, Jenniferen_US
dc.author.detailsGeorge Miller, RN, CCRN, CSC, email: george.miller@flaglerhospital.org; Jennifer Lofgrenen_US
dc.identifier.urihttp://hdl.handle.net/10755/183089-
dc.description.abstractPURPOSE: <br/>Prompt Percutaneous Coronary Intervention(PCI) for patients with ST Elevation Myocardial Infarction(STEMI) significantly reduces mortality and morbidity. We sought to review and compare the processes, employed at our institution, for minimizing preventable delays in &quot;Door-to-Balloon&quot; time, thus employing evidenced based practice to maximize patient outcome as we implemented American Heart Association(AHA) and American College of Cardiology(ACC) guidelines.<br/><br/>METHOD:<br/>We conducted a qualitative review of patients presenting to the Emergency Department with evolving STEMI. The multidisciplinary team included direct care nurses from the Emergency Department, Cardiac Cath Lab, Cardiovascular Nursing, technologists and physicians. Flagler direct care nurses are key members and facilitators of this multidisciplinary quality improvement team. Data gathering methods included participation in the setting, direct observation, staff interviews, and analysis of documents. The following nurse sensitive indicators, length of stay and cardiac arrest, are presented in relation to the &quot;Door-to-Balloon&quot; core measure for ST Elevation Myocardial Infarction. <br/><br/>FINDINGS:<br/>The data reflects Flagler Hospital's average &quot;Door-to-Balloon&quot; time from January 2007 through June 2008 and indicates continuous improvement as the process was refined. Significantly, this average &quot;Door-to-Balloon&quot; time is below the goal of 90 minutes or less for first quarter 2008 through second quarter 2008. Our mortality rate is 1.7% for Door-to-Balloon in less than 90 minutes (&lt; 90) for STEMI patients for first quarter 2007 through first quarter 2008. This compares very favorably with the National Registry of Myocardial Infarction (NRMI) national benchmark, 3% mortality rate. Also, Flagler Hospital's diagnostic related group data shows a 1.5-day decrease in length of stay for the STEMI patients who did not have a myocardial infarction.<br/><br/>DISCUSSION:<br/>Hospitals can achieve the recommended AHA and ACC guidelines for Door-to-Balloon time with specific process design efforts. The recommended best practices involve extensive interdisciplinary cooperation and collaboration. Following the prescribed steps will result in significant improvement in practice, outcomes and quality.en_GB
dc.date.available2011-10-28T16:14:05Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:14:05Z-
dc.conference.date2009en_US
dc.conference.name6th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostMagnet Hospitals of Floridaen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationKissimmee, Floridaen_US
dc.description6th Annual Florida Magnet Research Conference � Theme: Research at the Point of Care. Held 12-13 February 2009 at Gaylord Palms Resort and Convention Center, Kissimmee, Florida, USA.en_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.-
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