Evaluating Acute Chest Pain Management in the ED: A Focus on ECG Timing and Process Efficiency Open Access
Bernstein, Alexa (Fall 2024)
Abstract
Abstract
Background:
Acute chest pain is a leading cause of Emergency Department (ED) visits, requiring rapid evaluation to improve outcomes and reduce complications. Timely administration of an electrocardiogram (ECG) within 10 minutes of patient arrival is essential for diagnosing ST-Elevation Myocardial Infarction (STEMI) and Acute Coronary Syndrome (ACS). Variability in adherence to this guideline at Emory Saint Joseph’s Hospital (ESJH) highlighted the need to evaluate compliance and identify barriers to timely ECG completion.
Objective/Purpose:
This clinical practice guideline aimed to assess compliance with the American Heart Association (AHA) 10-minute ECG recommendation, identify operational barriers, and evaluate the impact of compliance on patient outcomes.
Methods:
A retrospective review of data from ESJH’s records and the AHA’s Get With The Guidelines®-Coronary Artery Disease (GWTG-CAD) registry was conducted, focusing on adult patients with confirmed STEMI or ACS during the four quarters of 2023. A survey was administered to ESJH ED nurses to identify barriers such as resource limitations and workflow inefficiencies. Data analysis included trends in compliance rates and survey feedback to assess challenges impacting performance.
Results:
Compliance rates with the 10-minute ECG guideline varied significantly: 62.5% in Q1, 100% in Q2, 80% in Q3, and 100% in Q4. Survey findings indicated critical barriers, including limited technician availability (52%), restricted booth access (44%), and patient registration delays (20%). Moderate familiarity with guidelines was also reported, underscoring the need for enhanced education and streamlined workflows to sustain performance.
Conclusion:
Adhering to the AHA’s 10-minute ECG standard is vital for timely diagnosis and improved outcomes for ACS patients. Addressing operational barriers, optimizing resource allocation, and implementing educational initiatives are critical to achieving consistent compliance. These efforts will enhance the quality of care, reduce complications, and maintain adherence to national guidelines in ED settings.
Keywords:
acute chest pain, emergency department, electrocardiogram, American Heart Association, acute coronary syndrome, guideline adherence, STEMI, nurse feedback, operational efficiency, diagnostic timeliness
Table of Contents
Table of Contents
Abstract.............................................................. 1
Introduction.......................................................... 2
Methods............................................................... 3
Results............................................................... 4
Discussion............................................................ 5
Conclusion............................................................ 6
References............................................................ 7
Appendices............................................................ 8
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Evaluating Acute Chest Pain Management in the ED: A Focus on ECG Timing and Process Efficiency () | 2025-05-01 10:18:33 -0400 |
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