2.50
Hdl Handle:
http://hdl.handle.net/10755/324154
Category:
Abstract
Type:
Presentation
Title:
Saving Hearts: Reducing Emergency Department Door-to-Electrocardiogram Times
Author(s):
Huber, Monica; Cline, Kristen; Huether, Robin; McMurphy, Patty; Vogelsang, Paula; Batterman, Tori; Schelhaas, Rebekah
Author Details:
Monica Huber, MSAS, RN; Kristen Cline, RN, CEN, CPEN, email: kristen.cline@sanfordhealth.org; Robin Huether, BSN, RN; Patty McMurphy, RN, CEN; Paula Vogelsang, BSN, RN, CEN; Tori Batterman, BSN, RN; Rebekah Schelhaas, RN, CEN
Abstract:
Evidence-based Practice Abstract Purpose: The American Heart Association (AHA) recommends that electrocardiograms (EKGs) be obtained on all potential Acute Coronary Syndrome (ACS) patients within ten minutes of Emergency Department (ED) arrival. This recommendation was not being met in one ED, and a need for improvement was identified. Compliance with this standard is required to maintain AHA Chest Pain Center Accreditation for the Medical Center. A bedside nurse with strong leadership potential was engaged to determine cause and solutions for this problem. Design: Project began as a staff development project and progressed to a quality assurance and performance improvement project. Setting: A 24-bed suburban teaching hospital and level-two trauma center with an average of 44,000 visits annually. Participants/Subjects: All patients of all ages who presented to the triage nurse with complaints of chest pain, shortness of breath, syncope or near syncope, weakness, and palpitations during the study were screened as potential ACS patients and an EKG was performed. All patient care staff, both licensed and unlicensed, were given EKG training and expected to participate. Methods: Literature reviews, process observations, and brainstorming sessions were completed to determine areas for improvement to decrease door-to-EKG times. Through direction from both administration and frontline leadership in the ED, a two-week trial was completed. This included staff education, the development of an EKG protocol, entry of an EKG order in triage, telephone notification to staff that an EKG is needed, immediate bedding of patients, purposeful placement of EKG machines, use of timers that went with patients from triage, and completion of the EKG prior to visitor entry. Facilitators were staffed 24/7 to ensure rapid-process change and team compliance. Real-time data was collected and feedback given to staff to motivate and encourage them to continue with the process. Results/Outcomes: The average Door-to-EKG time of 11 minutes was dramatically decreased. An average of 6.1 minutes was achieved during the first seven months with greater than 90% of EKGs completed within the ten minutes in subsequent months. Monthly surveillance is performed to ensure the benchmark continues to be met. Implications: Implementation of these nurse-driven changes to the EKG protocol and related interventions significantly improved door-to-EKG times for ACS patients arriving at the ED, and could be easily applied in similar facilities seeking to meet this critical benchmark. These changes were inspired and implemented by leaders at the bedside and supported by their management.
Keywords:
Reducing Time to ECG
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix 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. 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.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleSaving Hearts: Reducing Emergency Department Door-to-Electrocardiogram Timesen_GB
dc.contributor.authorHuber, Monicaen_GB
dc.contributor.authorCline, Kristenen_GB
dc.contributor.authorHuether, Robinen_GB
dc.contributor.authorMcMurphy, Pattyen_GB
dc.contributor.authorVogelsang, Paulaen_GB
dc.contributor.authorBatterman, Torien_GB
dc.contributor.authorSchelhaas, Rebekahen_GB
dc.author.detailsMonica Huber, MSAS, RN; Kristen Cline, RN, CEN, CPEN, email: kristen.cline@sanfordhealth.org; Robin Huether, BSN, RN; Patty McMurphy, RN, CEN; Paula Vogelsang, BSN, RN, CEN; Tori Batterman, BSN, RN; Rebekah Schelhaas, RN, CENen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324154-
dc.description.abstractEvidence-based Practice Abstract Purpose: The American Heart Association (AHA) recommends that electrocardiograms (EKGs) be obtained on all potential Acute Coronary Syndrome (ACS) patients within ten minutes of Emergency Department (ED) arrival. This recommendation was not being met in one ED, and a need for improvement was identified. Compliance with this standard is required to maintain AHA Chest Pain Center Accreditation for the Medical Center. A bedside nurse with strong leadership potential was engaged to determine cause and solutions for this problem. Design: Project began as a staff development project and progressed to a quality assurance and performance improvement project. Setting: A 24-bed suburban teaching hospital and level-two trauma center with an average of 44,000 visits annually. Participants/Subjects: All patients of all ages who presented to the triage nurse with complaints of chest pain, shortness of breath, syncope or near syncope, weakness, and palpitations during the study were screened as potential ACS patients and an EKG was performed. All patient care staff, both licensed and unlicensed, were given EKG training and expected to participate. Methods: Literature reviews, process observations, and brainstorming sessions were completed to determine areas for improvement to decrease door-to-EKG times. Through direction from both administration and frontline leadership in the ED, a two-week trial was completed. This included staff education, the development of an EKG protocol, entry of an EKG order in triage, telephone notification to staff that an EKG is needed, immediate bedding of patients, purposeful placement of EKG machines, use of timers that went with patients from triage, and completion of the EKG prior to visitor entry. Facilitators were staffed 24/7 to ensure rapid-process change and team compliance. Real-time data was collected and feedback given to staff to motivate and encourage them to continue with the process. Results/Outcomes: The average Door-to-EKG time of 11 minutes was dramatically decreased. An average of 6.1 minutes was achieved during the first seven months with greater than 90% of EKGs completed within the ten minutes in subsequent months. Monthly surveillance is performed to ensure the benchmark continues to be met. Implications: Implementation of these nurse-driven changes to the EKG protocol and related interventions significantly improved door-to-EKG times for ACS patients arriving at the ED, and could be easily applied in similar facilities seeking to meet this critical benchmark. These changes were inspired and implemented by leaders at the bedside and supported by their management.en_GB
dc.subjectReducing Time to ECGen_GB
dc.date.available2014-08-04T13:28:29Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:29Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix 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. 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_GB
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