Quality improvement project for door-to-EKG time for emergency room
Review TypeNone: Degree-based Submission
Repository Posting Date2020-06-24T21:53:32Z
Author DetailsJodi Dorrough, MS, RN, ANGELA SAATHOFF, DNP, RN, Faculty Mentor and Chair; LINDA MATHESON, PhD, Committee Member; CHRISTINA YERDON, MSN, ACNP-BC, MBA RN, Preceptor
Lead Author Sigma AffliationNon-member
TypeDNP Capstone Project
Level of EvidenceCase Study/Series
Research ApproachQuantitative Research
KeywordsRapid Triage Nurse Approach; Improving Door-to-EKG Time; Nurse Triage in Emergency Room; Recovering Arrival EKG from Nurse Triage; Emergency Service; Emergency Room; Emergency Department
The American Heart Association recommends the initiation of an EKG with interpretation in less than 10 minutes upon presentation to the emergency room for patients presenting with acute coronary symptoms. Treatment delay factors of identifying the importance and impact of triage within the initial contact for patients in the ER influenced to the implementation of an EKG- triage-RN intervention within the triage area. The EKG-triage-RN intervention redirected the flow of ACS patients as they enter the ER, in order to be evaluated and assessed faster for the potential of an immediate EKG. A quality improvement project was completed based on the concept of LEAN Six Sigma asking the following question: For nurses in the ER, will implementation of an EKG-triage-RN approach, compared to current practice, improve door to EKG time to meet the benchmark goal of 10 minutes or less, within a 10-week timeframe? Prior to the project, the average door-to-EKG time of 24 minutes, a compliance rate of EKG’s verified by the ER physician at 37.5% and first medical device time for walk-in ER patients of 96 minutes. Post implementation of an EKG-triage-RN data demonstrated a door-to-EKG time of 13 minutes, a compliance rate of 72.3% and first medical device time for walk-in ER patients of 85 minutes. Limitations in this project included were poor recognition of stated symptoms from patients walking into the ER thereby not allowing the EKG-triage-RN to recognize the need for an EKG. The project results were significant to the facility as a method to meeting benchmark standard goals.
Degree GrantorCapella University
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