Date of Award

2012

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Abstract

The Society of Chest Pain Centers (SCPC) has created a holistic model focused on providing best care to acute coronary syndrome (ACS) patients. The SCPC uses the American College of Cardiology/American Heart Association (ACC/AHA) guidelines to define best practice for treating ACS patients. The objective of this evidence-based practice project was to obtain SCPC accreditation at a rural hospital in Northwest Indiana and improve adherence with the ACC/AHA standards of care. In the literature, eighteen articles were reviewed and found to be level II or higher using Polit & Beck’s hierarchy of evidence. The literature review revealed that hospitals demonstrated higher rates of compliance with the ACC/AHA guidelines after becoming an accredited Chest Pain Center. Implementation of this EBP project included emergency department staff education on the SCPC accreditation process, and reinforcement of the importance of obtaining the patient’s ECG in less than ten minutes from his/her time of arrival in the emergency department. This hospital currently tracks ECG times and door to balloon times through a quality improvement process for all patients taken to the catheterization lab for ST-segment elevation myocardial infarctions (STEMI). For those patients presenting to the hospital with non- STEMI, ACS, or chest pain in general, a review of almost 6,000 charts was completed to analyze the ECG times for both admitted and discharged patients. The evaluation of this project was completed through comparing baseline door to ECG times and door to balloon times from the third quarter, to those of the fourth quarter of 2011. The recommendations following the implementation of this project would be that the hospital will maintain certification to improve patient outcomes and the health of the community.

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