Date of Award

2012

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

First Advisor

Janie M. Carlton

Abstract

The purpose of this study examined if an Emergency Department (ED) in a small rural hospital in western North Carolina is compliant with the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for obtaining Electrocardiogram's (ECG's), administering fibrinolytics, and performing Primary Percutaneous Coronary Intervention (PCI) on patients with chest pain diagnosed with ST-Elevation Myocardial Infarction (STEMI). The national standards for ECGs is less than 10 minutes from arrival to first medical contact (FMC) with triage nurse; for fibrinolytics, less than 30 minutes from arrival to FMC; and for FMC to PCI, less than 90 minutes. The national standard for ECG times is for all patients presenting to the ED with symptom of chest pain. The national standards for FMC to PCI and fibrinolytics are for STEMI patients only. Using a retrospective design, twenty-five patient records were examined from January 2010 to December 2011. The one-sample t test was used to compare the sample means for the ECG and FMC to PCI times to the national standards. The one sample t test revealed a significant difference in length of time between arrival to the ED and ECG between the sample and national standard. The length of time between arrival and ECG for the sample was significantly shorter that the national standard of 10 minutes or less. The length of time between FMC and PCI, although significantly different, was significantly longer than the national standard of 90 minutes. There was insufficient data to examine the length of time for the administration of fibrinolytics. Additional research is needed using a larger sample size as well as additional EDs that transfer patients for PCI.

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