Doctor of Nursing Practice (DNP) Projects

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Open Access

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

4-30-2016

Degree Program

Doctor of Nursing Practice

Degree Track

Post Master's DNP Completion

Year Degree Awarded

2016

Month Degree Awarded

May

Keywords

chest pain, acute coronary syndrome, triage, clinical guideline

Advisor Name

Jean

Advisor Last Name

DeMartinis

Capstone Chair First Name

Jean

Capstone Chair Last Name

DeMartinis

Capstone Member Name

Pamela

Aselton

Capstone Outside Member Name

Michelle

Gero

Abstract

Background: Heart disease remains the number one killer of Americans with an estimated 599,413 deaths in 2013 attributed to this condition and its treatment has inflated to an annual cost of $190 billion. This mortality is partially attributed to ineffective outpatient triage, management, and treatment of patients with acute chest pain. Methods: The purpose of this newly proposed acute chest pain triage and management guideline was: (1) to decrease inappropriate wait times and incongruous office appointments resulting in delay of care, patients being referred to the emergency room (ER) or, direct admissions to the hospital from the primary care office setting, and (2) to increase appropriate management for those patients experiencing the symptom of chest pain in the primary care setting by increasing the skill and comfort level of staff and providers in triaging and managing those patients in the primary care office setting. Results: Problem resolution was accomplished via employment of a multi-step acute chest pain guideline. This quality improvement plan (QIP) was successful in decreasing patients presenting to the primary care office with acute chest pain by 30.5%. Office staff and providers acquired a valuable resource and increased personal comfort level when triaging and managing acute chest pain in the outpatient primary care office setting. Conclusions: Sustainable use of the new guideline will promote cost savings for the primary care office and, more importantly, reduced delay of care and will reduce mortality rates for patients with acute chest pain.

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