Semester

Spring

Date of Graduation

2013

Document Type

Dissertation

Degree Type

DNP

College

School of Nursing

Department

Family/Community Health

Committee Chair

Susan McCrone

Committee Co-Chair

Dan DeFoe

Committee Member

Michael Mills.

Abstract

According to the American Heart Association (2010), in the United States every 36 seconds someone dies from heart and blood vessel disease. The Centers for Disease Control and Prevention (2007) estimate that one in six deaths in the US is related to coronary artery disease. When diagnosed with acute coronary syndrome, which is an acute event, resulting from CAD, appropriate treatment greatly reduces the risk of refractory ischemia, need for urgent revascularization, and death. Women are less likely to be urgently diagnosed with acute coronary syndrome, receive thrombolytic therapy, or undergo percutaneous coronary intervention than men, thereby increasing their mortality and morbidity (Bell et al., 1999). There is a need to educate the providers in a rural hospital's emergency department on the atypical signs and symptoms of acute coronary syndrome in women that present to the ED to facilitate emergent treatment. The objectives of the educational program were to increase provider knowledge about the atypical signs and symptoms of ACS with which women present to the ED as measured by an increase in CORE measures: TNKase in less than 30 minutes from arrival in the ED, number of women who received ASA in the ED, and EKG in less than 10 minutes from arrival at the ED.;This capstone project used a one group pretest -- posttest quasi-experimental design with a convenience sample of ED providers. The total number of eligible provider participants was 75. Fifty-four (72%) participated in the 39 minute educational intervention and completed both the pre and post-test. There was a 30% increase in provider knowledge from pre to post test, p<0.001. There were 23,385 patients seen in the ED during the intervention time frame. Of those, 1,182 met criteria for inclusion. There was a 52% increase in women who received TNKase in less than 30 minutes from their arrival time in the ED, a 0.8% increase in the number of women who received ASA in the ED and a 4% decrease in obtaining an EKG in less than 10 minutes. The intervention proved to be successful in increasing the knowledge of providers in the recognition of atypical signs and symptoms of ACS, increasing the number of women who received ASA in less than 10 minutes, increasing TNKase administration in less than 30 minutes, and minimally increasing EKG administration. Further follow-up is warranted on the impact of the intervention longitudinally.

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