Improving Door-to-ECG Time for Patients Presenting With Chest Pain in the Adult Emergency Department
Diana Lyn Baptiste, DNP, MSN, RN; Barbara Maliszewski; Heather Gardner; Cathleen Lindauer
- Sigma Affiliation
- Nu Beta at-Large
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Baptiste, Diana Lyn by View
Popular Works for Baptiste, Diana Lyn by Download
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).
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.
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.
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.
|Review Type||Abstract Review Only: Reviewed by Event Host|
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subjects.
Outcomes of an Innovative Evidence-Based Project: Building a Difficult Access Team in an Emergency Department Baptiste, Diana Lyn; Maliszewski, Barbara; Whalen, Madeleine; Gardner, Heather; Sheinfeld, Rebecca (2017-07-06)Background/Introduction: Emergency departments across the nation face challenges of longer lengths of stay due to increased volumes and patient acuity. Intravenous (IV) access is vital to emergency care, and a large ...
Using electronic nursing handoff to improve timeliness of clinical information exchange and reduce boarding time for admitted patients in the emergency department Huffman, Linda; Burnett, Margie; Beitler, Donna; Perrin, Keisha; Zabko, Candice; Del Pilar, Ashley; Gardner, Heather; Rutledge, Cindy; Rupani, Hetal; Mehta, Radhika; Maliszewski, BarbaraSession C presented Thursday, September 27, 1:00-2:00 pm Purpose: Boarding patients in the Emergency Department (ED) can heighten risk for higher morbidity and mortality, and longer length of stay. ED boarding is a function ...
Baptiste, Diana Lyn; Maliszewski, Barbara; Whalen, Madeleine (2017-09-29)The literature emphasizes the importance of recognizing factors that contribute to difficult venous access for patients. It also supports the use of designated difficult access teams. Use of designated difficult access ...
Baptiste, Diana Lyn; Neira, Paula M.; Maliszewski, Barbara; Toledo, RaniMaria; Borries, Kimberly (2016-07-13)Session presented on Friday, July 22, 2016 and Thursday, July 21, 2016: Background: In the evolving health care marketplace, competition between health care organizations is driven by accreditation requirements, patient ...
Implementation of an Intervention to Increase Number of Certified Nurses in an Emergency Medicine Department Toledo, RaniMaria; Neira, Paula M.; Maliszewski, Barbara; Baptiste, Diana Lyn; Borries, Kimberly (2016-03-29)Session presented on Saturday, April 9, 2016, and Friday, April 8, 2016: Background: In the evolving health care marketplace, competition between health care organizations is driven by accreditation requirements, patient ...