2.50
Hdl Handle:
http://hdl.handle.net/10755/344141
Category:
Abstract
Type:
Poster
Title:
Chasing the Goal for First Medical Contact to Balloon Time
Author(s):
Vanairsdale, Sharon
Lead Author STTI Affiliation:
Non-member
Author Details:
Sharon Vanairsdale, MS, APRN, CEN, ACNS-BC, NP-C, sharon.vanairsdale@emoryhealthcare.org
Abstract:
Evidence-based Practice Abstract Purpose: According to the American Heart Association, nearly 250,000 people experience ST-segment elevation myocardial infarction (STEMI) per year. Hospitals are now partnering with Emergency Medical Services (EMS) to quickly restore blood flow to the blocked arteries in the heart. In addition to measuring hospital arrival to restore of blood flow, many hospitals are now measuring first medical contact, defined as the time EMS arrives to the patient, to the intervention time. The goal for this project was to achieve First Medical Contact to Balloon (FMC2B) time in less than or equal to 90 minutes in a minimum of 75% of STEMI patients. Design: The evidence-based project was developed by an interdisciplinary team including nurses and physicians from the ED and cath lab in addition to EMS colleagues. Every STEMI case was reviewed for quality assurance, and data and feedback were provided to EMS, ED, and cath lab team members. Setting: The hospital is an academic, urban non-trauma Magnet® facility with 579 beds located in the Southeastern United States with approximately 24,000 inpatient and 80,000 outpatient visits annually. The Emergency Department is a 32-bed unit with approximately 37,500 annual visits and 76 STEMI admissions, 78% arriving by EMS. Prior to the start of the project, the goal of 90 minutes or less was met 0% of the time for the previous four quarters. Participants/Subjects: Emergency Department patients arriving by EMS with an initial 12-lead ECG evident of STEMI. Methods: Using standard QI methods including process flow diagrams, the following practices were identified for improvements: communication between EMS and the ED; pre-hospital transmission of ECGs; and cath lab readiness to receive the patient. Biweekly meetings were used to design and conduct multiple PDSA cycles for each identified process improvement focus. Results/Outcomes: As a result of the hospital’s focus, in January 2012, the hospital achieved FMC2B time within 90 minutes for the first time and in April 2012, reached 100% for the month. In July and August 2012, the hospital achieved FMC2B time in equal to or less than 90 minutes for 75% of patients. By working with EMS and the ED to increase the rate of pre-hospital cath lab activation, the hospital was able to meet our objective of achieving the 90-minute target in equal to greater than 75% of patients in quarter 3 of 2012. Despite variability in early 2013, the hospital has sustained the results and achieved our target for three consecutive quarters in 2013. Implications: Activating the cath lab prior to the patient’s arrival was critical to achieve the 90-minute target and improve the quality of patient care. Knowing TIME = MUSCLE, patients having a STEMI benefit from timely interventions. Nurses, physicians, and EMS colleagues exemplified patient-centered care as they changed practice and adopted new behaviors to expedite patients to the cath lab. Interprofessional collaboration between EMS, the ED, and cath lab was necessary to deliver the best care possible for patients having a STEMI.
Keywords:
STEMI; First Medical Contact to Balloon time
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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.typePosteren_GB
dc.titleChasing the Goal for First Medical Contact to Balloon Timeen_GB
dc.contributor.authorVanairsdale, Sharonen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsSharon Vanairsdale, MS, APRN, CEN, ACNS-BC, NP-C, sharon.vanairsdale@emoryhealthcare.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344141-
dc.description.abstractEvidence-based Practice Abstract Purpose: According to the American Heart Association, nearly 250,000 people experience ST-segment elevation myocardial infarction (STEMI) per year. Hospitals are now partnering with Emergency Medical Services (EMS) to quickly restore blood flow to the blocked arteries in the heart. In addition to measuring hospital arrival to restore of blood flow, many hospitals are now measuring first medical contact, defined as the time EMS arrives to the patient, to the intervention time. The goal for this project was to achieve First Medical Contact to Balloon (FMC2B) time in less than or equal to 90 minutes in a minimum of 75% of STEMI patients. Design: The evidence-based project was developed by an interdisciplinary team including nurses and physicians from the ED and cath lab in addition to EMS colleagues. Every STEMI case was reviewed for quality assurance, and data and feedback were provided to EMS, ED, and cath lab team members. Setting: The hospital is an academic, urban non-trauma Magnet® facility with 579 beds located in the Southeastern United States with approximately 24,000 inpatient and 80,000 outpatient visits annually. The Emergency Department is a 32-bed unit with approximately 37,500 annual visits and 76 STEMI admissions, 78% arriving by EMS. Prior to the start of the project, the goal of 90 minutes or less was met 0% of the time for the previous four quarters. Participants/Subjects: Emergency Department patients arriving by EMS with an initial 12-lead ECG evident of STEMI. Methods: Using standard QI methods including process flow diagrams, the following practices were identified for improvements: communication between EMS and the ED; pre-hospital transmission of ECGs; and cath lab readiness to receive the patient. Biweekly meetings were used to design and conduct multiple PDSA cycles for each identified process improvement focus. Results/Outcomes: As a result of the hospital’s focus, in January 2012, the hospital achieved FMC2B time within 90 minutes for the first time and in April 2012, reached 100% for the month. In July and August 2012, the hospital achieved FMC2B time in equal to or less than 90 minutes for 75% of patients. By working with EMS and the ED to increase the rate of pre-hospital cath lab activation, the hospital was able to meet our objective of achieving the 90-minute target in equal to greater than 75% of patients in quarter 3 of 2012. Despite variability in early 2013, the hospital has sustained the results and achieved our target for three consecutive quarters in 2013. Implications: Activating the cath lab prior to the patient’s arrival was critical to achieve the 90-minute target and improve the quality of patient care. Knowing TIME = MUSCLE, patients having a STEMI benefit from timely interventions. Nurses, physicians, and EMS colleagues exemplified patient-centered care as they changed practice and adopted new behaviors to expedite patients to the cath lab. Interprofessional collaboration between EMS, the ED, and cath lab was necessary to deliver the best care possible for patients having a STEMI.en_GB
dc.subjectSTEMIen_GB
dc.subjectFirst Medical Contact to Balloon timeen_GB
dc.date.available2015-02-04T11:27:13Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:13Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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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