Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Degree Program
Doctor of Nursing Practice
Degree Track
Post Master's DNP Completion
Year Degree Awarded
2016
DOI
https://doi.org/10.7275/8543761
Month Degree Awarded
May
Keywords
chest pain, acute coronary syndrome, triage, clinical guideline
Advisor
Jean DeMartinis
DNP Project Chair
Jean DeMartinis
DNP Project Member Name
Pamela Aselton
DNP Project 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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