Improving Door-to-ECG Time for Patients Presenting With Chest Pain in the Adult Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/621941
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Improving Door-to-ECG Time for Patients Presenting With Chest Pain in the Adult Emergency Department
Author(s):
Baptiste, Diana Lyn; Maliszewski, Barbara; Gardner, Heather; Lindauer, Cathleen
Lead Author STTI Affiliation:
Nu Beta
Author Details:
Diana Lyn Baptiste, DNP, MSN, RN, Professional Experience: 2015-Present -- Assistant Professor, Johns Hopkins University School of Nursing, Baltimore, MD 2015-Present - Evidence-based Practice Nurse, Emergency Medicine Department- Johns Hopkins Hospital, Baltimore, MD 2013-Present -- Faculty Associate, Johns Hopkins University School of Nursing, Baltimore, MD 2007-2013 -- Supplemental Staff Nurse--Greater Baltimore Medical Center, Towson, MD 2010-2011 -- Clinical Instructor--Johns Hopkins University School of Nursing, Baltimore, MD 2006-2009 - Supplemental Staff Nurse--Franklin Square Hospital, Baltimore, MD 2000-2006- Staff Nurse- Mercy Medical Center, Baltimore, MD Volunteers on Medical Missions in Haiti Has published and presented internationally Sigma Theta Tau International Society of Nursing, Nu Beta Chapter, President Author Summary: Dr. Baptiste has had a 15-year nursing career devoted to caring for adults, specializing in cardiovascular prevention and health care. She has recently joined the Johns Hopkins Hospital Emergency Medicine Leadership Team, assisting nurse leaders working on various quality improvement projects. Dr. Baptiste has published in areas of heart failure and cultural humility. She has presented nationally and internationally in areas of nursing education with a promoting nurse competencies in acute-care clinical settings.
Abstract:

Purpose:

The American Heart Association/ American College of Cardiology guidelines recommend rapid door-to-electrocardiography (ECG) times for patients who present with chest pain. Reducing ECG-to-door time is important so that health care providers adhere to the recommended door-to-balloon times (less than or equal to 90 minutes) for patients who present with ST-segment elevation myocardial infarction (STEMI).

The objective of this quality improvement project was to measure the mean time that it takes to obtain an electrocardiography (ECG) for patients who present to the emergency department with complaints of chest pain. The goal of this project was develop and evaluate an intervention that promote meeting the American Heart Association/ American College of Cardiology standard for ECG-to-door time of less than 10 minutes upon patients’ arrival to the emergency department (ED).

Methods:

We implemented a door-to-ECG protocol that included moving the ECG station to a specialized area in triage, where patients can quickly receive an ECG upon arrival to the ED. Patients who presented to the ED with complaints of chest pain were provided with a red heart symbol as an indicator for clinical technicians to identify those in need of an ECG, and process them quickly. Pre and post intervention data was collected over a six-month period.

Results:

Prior to the intervention, the mean door-to-ECG time was 21minutes among (N=292) patients over three months. After the intervention, the mean door-to ECG time for (N=701) patients was 10.6 minutes, over the next 3 months. Initially, the percentage of compliance with door-to ECG standard was 26% and improved to 73% after implementation of the door-to ECG protocol. We found that door-to-EKG times for patients who walked in to the ED were relatively shorter than those who arrived via ambulance.

 

Conclusion:

The overall door-to-ECG compliance improved by 47% in the post intervention period. By implementing a door-to ECG protocol, we not only improved door-to ECG-times, potentially decreasing door-to-balloon times for patients who presented with STEMI. Door-to-EKG times may vary among method of arrival. Further investigation is warranted to evaluate door-to-balloon times for patients with STEMI, and for development of strategies to improve door-to-EKG times for patients arriving via ambulance.

Keywords:
Cardiovascular; Electrocardiography; Myocardial Infarction
Repository Posting Date:
19-Jul-2017
Date of Publication:
19-Jul-2017
Other Identifiers:
INRC17PST65
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleImproving Door-to-ECG Time for Patients Presenting With Chest Pain in the Adult Emergency Departmenten_US
dc.contributor.authorBaptiste, Diana Lynen
dc.contributor.authorMaliszewski, Barbaraen
dc.contributor.authorGardner, Heatheren
dc.contributor.authorLindauer, Cathleenen
dc.contributor.departmentNu Betaen
dc.author.detailsDiana Lyn Baptiste, DNP, MSN, RN, Professional Experience: 2015-Present -- Assistant Professor, Johns Hopkins University School of Nursing, Baltimore, MD 2015-Present - Evidence-based Practice Nurse, Emergency Medicine Department- Johns Hopkins Hospital, Baltimore, MD 2013-Present -- Faculty Associate, Johns Hopkins University School of Nursing, Baltimore, MD 2007-2013 -- Supplemental Staff Nurse--Greater Baltimore Medical Center, Towson, MD 2010-2011 -- Clinical Instructor--Johns Hopkins University School of Nursing, Baltimore, MD 2006-2009 - Supplemental Staff Nurse--Franklin Square Hospital, Baltimore, MD 2000-2006- Staff Nurse- Mercy Medical Center, Baltimore, MD Volunteers on Medical Missions in Haiti Has published and presented internationally Sigma Theta Tau International Society of Nursing, Nu Beta Chapter, President Author Summary: Dr. Baptiste has had a 15-year nursing career devoted to caring for adults, specializing in cardiovascular prevention and health care. She has recently joined the Johns Hopkins Hospital Emergency Medicine Leadership Team, assisting nurse leaders working on various quality improvement projects. Dr. Baptiste has published in areas of heart failure and cultural humility. She has presented nationally and internationally in areas of nursing education with a promoting nurse competencies in acute-care clinical settings.en
dc.identifier.urihttp://hdl.handle.net/10755/621941-
dc.description.abstract<p><strong>Purpose:</strong></p> <p>The American Heart Association/ American College of Cardiology guidelines recommend rapid door-to-electrocardiography (ECG) times for patients who present with chest pain. Reducing ECG-to-door time is important so that health care providers adhere to the recommended door-to-balloon times (less than or equal to 90 minutes) for patients who present with ST-segment elevation myocardial infarction (STEMI).</p> <p>The objective of this quality improvement project was to measure the mean time that it takes to obtain an electrocardiography (ECG) for patients who present to the emergency department with complaints of chest pain. The goal of this project was develop and evaluate an intervention that promote meeting the American Heart Association/ American College of Cardiology standard for ECG-to-door time of less than 10 minutes upon patients’ arrival to the emergency department (ED).<strong></strong></p> <p><strong>Methods:</strong></p> <p>We implemented a door-to-ECG protocol that included moving the ECG station to a specialized area in triage, where patients can quickly receive an ECG upon arrival to the ED. Patients who presented to the ED with complaints of chest pain were provided with a red heart symbol as an indicator for clinical technicians to identify those in need of an ECG, and process them quickly. Pre and post intervention data was collected over a six-month period.<strong></strong></p> <p><strong>Results:</strong></p> <p>Prior to the intervention, the mean door-to-ECG time was 21minutes among (N=292) patients over three months. After the intervention, the mean door-to ECG time for (N=701) patients was 10.6 minutes, over the next 3 months. Initially, the percentage of compliance with door-to ECG standard was 26% and improved to 73% after implementation of the door-to ECG protocol. We found that door-to-EKG times for patients who walked in to the ED were relatively shorter than those who arrived via ambulance.</p> <p> </p> <p><strong>Conclusion:</strong></p> <p>The overall door-to-ECG compliance improved by 47% in the post intervention period. By implementing a door-to ECG protocol, we not only improved door-to ECG-times, potentially decreasing door-to-balloon times for patients who presented with STEMI. Door-to-EKG times may vary among method of arrival. Further investigation is warranted to evaluate door-to-balloon times for patients with STEMI, and for development of strategies to improve door-to-EKG times for patients arriving via ambulance.</p>en
dc.subjectCardiovascularen
dc.subjectElectrocardiographyen
dc.subjectMyocardial Infarctionen
dc.date.available2017-07-19T18:14:36Z-
dc.date.issued2017-07-19-
dc.date.accessioned2017-07-19T18:14:36Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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