2.50
Hdl Handle:
http://hdl.handle.net/10755/198354
Title:
Electrocardiograms in Triage in Ten Minutes all of the Time
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Electrocardiograms in Triage in Ten Minutes all of the Time

Purpose: The Emergency Department patient volumes have grown steadily as well as the acuity of patients has risen over the past two years. The Emergency Department treats about 300 patients a month who present with cardiac symptoms. However, the process of obtaining an EKG on a patient for high risk of a ST Elevated Myocardial Infarction (STEMI) would vary. Patients would either receive an EKG in the waiting room, after being triaged, or after being taken back to a care space. This lack of standardization led to the failure of the team to obtain an EKG in ten minutes as recommended by the American Heart Association (AHA). The Emergency Department nurses and physicians identified this issue as an opportunity for improvement at a Town Hall Meeting.

Design: The team developed a detailed process flow to complete 100% of EKGs within 10 minutes of patient arrival for patients who were at risk for a heart attack as well as creating a consistent point of contact for all EKGs to be read in a timely manner.

Setting: An academic medical center Emergency Department with Level One trauma status in the Midwest.

Participants: The triage nurse in the Emergency Department Waiting Room, the Emergency Department Assistants and Emergency Department Physicians.

Methods: The Triage Nurse identifies appropriate patients to have an EKG completed immediately by a dedicated Emergency Department Assistant (EDA). The EDA is available via phone and has a dedicated private room in the waiting area to complete the EKG. The EDA presents the completed EKG to the designated Attending Physician. Patients assessed to be at risk are placed immediately in a care space by the Triage Nurse or Charge Nurse. The completion times of EKG performed on at risk patients are reported monthly to the Emergency Department Team.

Results/ Outcomes: This process has been in place since October 2009. EKGs completed in 10 minutes have risen from an average of 10% to greater than 80% for all patients and near 100% for STEMI patients.

Implications: The EKGs in ten minutes process flow has ensured that patients presenting with a STEMI are able to receive the appropriate care as defined by the AHA. Since implementation of this new process 100% of STEMI patients arriving to the Emergency Department have achieved the AHA goal of Door to Balloon Time of 90 Minutes. Not only has this process provided safer care for all of our Emergency Department Patients but it has empowered the Emergency Department Team. This process was developed by a multi-discipline team approach and has encouraged the team to identify and change patient quality processes.

Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleElectrocardiograms in Triage in Ten Minutes all of the Timeen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198354-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Electrocardiograms in Triage in Ten Minutes all of the Time<br/> <br/>Purpose: The Emergency Department patient volumes have grown steadily as well as the acuity of patients has risen over the past two years. The Emergency Department treats about 300 patients a month who present with cardiac symptoms. However, the process of obtaining an EKG on a patient for high risk of a ST Elevated Myocardial Infarction (STEMI) would vary. Patients would either receive an EKG in the waiting room, after being triaged, or after being taken back to a care space. This lack of standardization led to the failure of the team to obtain an EKG in ten minutes as recommended by the American Heart Association (AHA). The Emergency Department nurses and physicians identified this issue as an opportunity for improvement at a Town Hall Meeting. <br/><br/>Design: The team developed a detailed process flow to complete 100% of EKGs within 10 minutes of patient arrival for patients who were at risk for a heart attack as well as creating a consistent point of contact for all EKGs to be read in a timely manner. <br/><br/>Setting: An academic medical center Emergency Department with Level One trauma status in the Midwest.<br/><br/>Participants: The triage nurse in the Emergency Department Waiting Room, the Emergency Department Assistants and Emergency Department Physicians.<br/><br/>Methods: The Triage Nurse identifies appropriate patients to have an EKG completed immediately by a dedicated Emergency Department Assistant (EDA). The EDA is available via phone and has a dedicated private room in the waiting area to complete the EKG. The EDA presents the completed EKG to the designated Attending Physician. Patients assessed to be at risk are placed immediately in a care space by the Triage Nurse or Charge Nurse. The completion times of EKG performed on at risk patients are reported monthly to the Emergency Department Team.<br/><br/>Results/ Outcomes: This process has been in place since October 2009. EKGs completed in 10 minutes have risen from an average of 10% to greater than 80% for all patients and near 100% for STEMI patients.<br/><br/>Implications: The EKGs in ten minutes process flow has ensured that patients presenting with a STEMI are able to receive the appropriate care as defined by the AHA. Since implementation of this new process 100% of STEMI patients arriving to the Emergency Department have achieved the AHA goal of Door to Balloon Time of 90 Minutes. Not only has this process provided safer care for all of our Emergency Department Patients but it has empowered the Emergency Department Team. This process was developed by a multi-discipline team approach and has encouraged the team to identify and change patient quality processes. <br/><br/>en_GB
dc.date.available2011-12-21T12:47:06Z-
dc.date.issued2011-12-21T12:47:06Z-
dc.date.accessioned2011-12-21T12:47:06Z-
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