Promoting Inter-professional Education to Improve Door-to-Balloon Times in ST-Elevation Myocardial Infarctions

2.50
Hdl Handle:
http://hdl.handle.net/10755/306600
Category:
Abstract
Type:
Poster
Title:
Promoting Inter-professional Education to Improve Door-to-Balloon Times in ST-Elevation Myocardial Infarctions
Author(s):
Leising, Elizabeth; Degan, Jennifer
Lead Author STTI Affiliation:
Non-member
Author Details:
Elizabeth Leising, BSN, RN, CEN; Jennifer Degan, BSN, RN, jdegan@iuhealth.org
Abstract:

Evidence-based Practice Abstract

Purpose: A 2009 update by the American College of Cardiology Foundation/American Heart Association Task Force recommends an as-soon-as-possible standard for primary PCI in place of the previous 90-minute door-to-balloon benchmark. To improve door-to-balloon times, external factors were identified and an Inter Professional Education approach was taken to improve EMS arrival times.

Design: Quality improvement (QI) project.

Setting: Community Based Emergency Department with 45,000 patient visits in 2011.

Participants: 100 ED RN’s, EMT’s, EMT-P’s, Unit Secretaries and ED Physicians, currently employed in the ED as patient caregivers. Thirty EMT’s and EMT-P’s employed by a private EMS service responsible for primary transfer of ST-Elevation Myocardial Infarction (STEMI) patients.

Methods: Prior to beginning this effort, internal factors had previously been maximized therefore external factors were addressed in this QI project. Without a dedicated cardiac catheterization lab, many STEMI patients needed to be transported, resulting in longer door-to-balloon times. In an effort to improve those times, a literature search was conducted to identify best practice for STEMI care and transport. Upon review, the external factor that would have the greatest impact on reducing time and had a measurable outcome was identified as call to EMS arrival. To decrease the wait time for EMS arrival, a partnership was formed with a private EMS company that provided an onsite ALS ambulance for immediate transportation of STEMI patients. This partnership resulted in the need for Inter Professional Education to ensure quick and seamless transport of STEMI patients and verify the highest level of care is given. An educational program was developed and presented by the ED clinical educator and ED physician to a multidisciplinary group of 100 staff members at mandatory staff meetings and small group meetings. The same educational program, along with simulation training, was presented to thirty private EMS staff over two mandatory meetings and an implementation date was set. Call to EMS arrival time, along with overall door-to-balloon time was monitored for effectiveness of program beginning the first week of January 2012.

Results: 2011 average call to EMS arrival times were approximately 10 minutes. As of June 2012, six months after initiation of program, preliminary call to EMS times are now 3.5 minutes. Advantages cited include providing quicker door-to-balloon times by stream-lining an external process and decreasing call to EMS arrival times. In 2011 the average, overall door-to-balloon time was 84 minutes. Currently 2012 year to date door-to-balloon average is approximately 75 minutes.

Implications: Identifying external factors that affect door-to-balloon times in STEMI patients and addressing those factors utilizing an Inter Professional Education approach, resulted in improvements made to the overall time to intervention for this high risk patient group. Working to change what the ED could impact has gained valuable time which can provide those precious minutes making the difference between life and death for the patients in the community. Further monitoring of patient outcomes and door-to-balloon times is planned.

Keywords:
Improving Door-to-Balloon Times
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Ft. Lauderdale, Florida, USA
Description:
2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Center
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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titlePromoting Inter-professional Education to Improve Door-to-Balloon Times in ST-Elevation Myocardial Infarctionsen_GB
dc.contributor.authorLeising, Elizabethen_GB
dc.contributor.authorDegan, Jenniferen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsElizabeth Leising, BSN, RN, CEN; Jennifer Degan, BSN, RN, jdegan@iuhealth.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306600-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: A 2009 update by the American College of Cardiology Foundation/American Heart Association Task Force recommends an as-soon-as-possible standard for primary PCI in place of the previous 90-minute door-to-balloon benchmark. To improve door-to-balloon times, external factors were identified and an Inter Professional Education approach was taken to improve EMS arrival times.</p><p>Design: Quality improvement (QI) project.</p><p>Setting: Community Based Emergency Department with 45,000 patient visits in 2011.</p><p>Participants: 100 ED RN’s, EMT’s, EMT-P’s, Unit Secretaries and ED Physicians, currently employed in the ED as patient caregivers. Thirty EMT’s and EMT-P’s employed by a private EMS service responsible for primary transfer of ST-Elevation Myocardial Infarction (STEMI) patients.</p><p>Methods: Prior to beginning this effort, internal factors had previously been maximized therefore external factors were addressed in this QI project. Without a dedicated cardiac catheterization lab, many STEMI patients needed to be transported, resulting in longer door-to-balloon times. In an effort to improve those times, a literature search was conducted to identify best practice for STEMI care and transport. Upon review, the external factor that would have the greatest impact on reducing time and had a measurable outcome was identified as call to EMS arrival. To decrease the wait time for EMS arrival, a partnership was formed with a private EMS company that provided an onsite ALS ambulance for immediate transportation of STEMI patients. This partnership resulted in the need for Inter Professional Education to ensure quick and seamless transport of STEMI patients and verify the highest level of care is given. An educational program was developed and presented by the ED clinical educator and ED physician to a multidisciplinary group of 100 staff members at mandatory staff meetings and small group meetings. The same educational program, along with simulation training, was presented to thirty private EMS staff over two mandatory meetings and an implementation date was set. Call to EMS arrival time, along with overall door-to-balloon time was monitored for effectiveness of program beginning the first week of January 2012.</p><p>Results: 2011 average call to EMS arrival times were approximately 10 minutes. As of June 2012, six months after initiation of program, preliminary call to EMS times are now 3.5 minutes. Advantages cited include providing quicker door-to-balloon times by stream-lining an external process and decreasing call to EMS arrival times. In 2011 the average, overall door-to-balloon time was 84 minutes. Currently 2012 year to date door-to-balloon average is approximately 75 minutes.</p><p>Implications: Identifying external factors that affect door-to-balloon times in STEMI patients and addressing those factors utilizing an Inter Professional Education approach, resulted in improvements made to the overall time to intervention for this high risk patient group. Working to change what the ED could impact has gained valuable time which can provide those precious minutes making the difference between life and death for the patients in the community. Further monitoring of patient outcomes and door-to-balloon times is planned.</p>en_GB
dc.subjectImproving Door-to-Balloon Timesen_GB
dc.date.available2013-12-09T17:00:33Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T17:00:33Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationFt. Lauderdale, Florida, USAen_GB
dc.description2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Centeren_GB
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.en_GB
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