Date of Award

Summer 2024

Project Type

Thesis

College or School

CHHS

Department

Nursing

Program or Major

Direct Entry Master's in Nursing

Degree Name

Master of Science

First Advisor

Pamela Kallmerten

Second Advisor

Elizabeth Evans

Abstract

Abstract Background: Acute Coronary Syndrome (ACS) and unspecified chest pain are common presentations in the Emergency Department (ED). Proper management, including appropriate oxygen supplementation, is crucial for optimal patient outcomes. However, discrepancies between current practice and evidence-based guidelines have been identified, highlighting a need for targeted educational interventions.

Local Problem: In the ED, knowledge gaps among nurses regarding the correct administration of supplemental oxygen for patients with ACS and unspecified chest pain have been observed. This inconsistency with the American Heart Association (AHA) and American College of Cardiology (ACC) guidelines may lead to poor patient outcomes.

Methods: The Plan-Do-Study-Act (PDSA) model was used to guide a Quality Improvement (QI) project focused on enhancing protocol adherence through nurse education. The intervention included developing educational materials based on the latest chest pain and oxygen supplementation guidelines, the implementation of training sessions utilizing the educational materials, and performing informal interviews and anonymous surveys to identify knowledge gaps. Pre- and post-intervention surveys were used to evaluate the effectiveness of the educational intervention.

Results: The educational intervention significantly improved nurses' knowledge and adherence to the chest pain protocol regarding oxygen supplementation. Post-intervention assessments showed a marked increase in the correct application of guidelines from 44% adherence rate to 79% adherence rate. Improved adherence was hypothesized to be associated with better patient outcomes, including reduced adverse events related to hyperoxia.

Conclusions: This QI project successfully addressed the knowledge gaps among ED nurses and aligned clinical practice with evidence-based guidelines. The intervention's sustainability is supported by ongoing training and periodic assessments. The QI project's framework can be adapted for other clinical settings and practices, offering broad implications for improving patient care. Future QI initiatives should build on these findings to further enhance clinical practice and patient outcomes.

Keywords: Acute Coronary Syndrome, Chest Pain, Emergency Department, Oxygen Supplementation, Quality Improvement, Nurse Education, Evidence-Based Practice, Patient Safety.

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