Guideline to Reduce Door-to-ECG Time Within the Emergency Department

Background: The American College of Cardiology and the American Heart Association recommend an electrocardiogram be obtained and interpreted within 10-minutes of arrival to improve patient outcomes. Research findings suggest that only 7.4% of patients that presented to the emergency department had an electrocardiogram performed in the first 10-minutes of arrival as recommended by the American College of Cardiology. Purpose: The purpose of this project was to implement and evaluate a quality improvement initiative subsequently improving the door-to-electrocardiogram time. Methods: The foundation of the Doctoral of Nursing Project was based using the Johns Hopkins Nursing Evidence-Based Practice Model. The evidence was used to inform guideline construction. The guideline was implemented into practice using the Plan-Do-Study-Act model. The PICOT question for the project was: In patients who presented to the emergency department with a complaint of chest pain, how did implement a guideline effect obtaining an electrocardiogram within 10-minutes? Evaluation: Statistical analysis was performed using SPSS version 25 software. Data were cleaned and checked prior to analysis. The mean differences between pre-and-post implementation groups in regards to door-to-ECG times were compared using ​t-test analysis. The significance level was 0.05. The t-test determined the means of the pre-post implementation data sets differed significantly. A statistician was consulted for additional guidance, as one was available for consultation. Results: Before implementation, the mean door-to-ECG time was 28.8-minutes. Post-implementation, the mean door-to-ECG time was 16.6-minutes. A t-test to compare the means of the door-to-ECG times from September 2018 and May 2019 using a level of significance of 0.05 identified a statistical difference between the pre–and post-implementation groups. The t-test demonstrated there was a correlation to the intervention and the door-to-ECG time.D.N.P., Nursing Practice -- Drexel University, 201