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Nursing Leadership & Management Field Experience - Essay Example

Summary
The paper "Nursing Leadership & Management Field Experience" states that the authors note that most of the time lost is on the acquisition of an electrocardiogram and most of the patients never had an electrocardiogram conducted on them because of delays. …
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Extract of sample "Nursing Leadership & Management Field Experience"

Annotated Bibliography Affiliation . Annotated bibliography Amruthlal Jain, S., Ismail, Y., Shaw, M., David, S., & Alexander, P. (2012). "Register and Roll": A Novel Initiative to Improve First Door-to-Balloon Time in ST-Elevation Myocardial Infarction. Cardiology Research & Practice, 1-4. doi:10.1155/2012/616940 There remains a compliance of 8.6 % with the guidelines of less than 90 minutes in caring for STEMI patients who need referral to PCI capable hospitals. The study confirms that EMS activation is the major delay of reperfusion time of these patients. The register and roll program is aimed at streamlining the triage process and improve transfer times within hospitals. The initiative has been useful in community hospitals that do not have the PCI capabilities. Attard Biancardi, M. A. (2013). Door-to-balloon time in primary percutaneous coronary intervention for patients with ST-Segment Elevation Myocardial Infarction An audit from the Accident and Emergency department of Mater Dei Hospital, Malta. Malta Medical Journal, 25(4), 2-9. A study conducted in the Maltese island to determine the compliance with set standards by the American heart association. From the study, it is clear that the target is not met with a patient that are come in office hours (8a.m to 5p.m) having a shorter DBT. At the same time, patients who came in with the Pre-hospital electrocardiogram had an even shorter DBT. However, patients attend solely in the hospital, did not meet the target with the average DBT time being recorded as 101minutes Balloon Times Ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-Lead ECG Project. Circulation: Cardiovascular Interventions, 2(6), 528-534. The authors appreciate the recommendation of the American heart association that at least 75 % STEMI patients should receive care within the first 90 minutes. At the same time, the authors agree to the fact that the goal of attending to 75 % of the patients within 90 minutes has been hard to achieve. Thus, they proposed a Prehospital 12 lead triage to help in achieving the goal. From the study, there was a phenomenal increased in the percentage of patients who received that care within the time. It was increased by 8% after initiation of the pre-hospital 12 lead triaging. Bradley, E. H., Curry, L. A., Ramanadhan, S., Rowe, L., Nembhard, I. M., & Krumholz, H. M. (2009). Research in action: using positive deviance to improve the quality of health care. Implementation Science, 4(1), 25. The author argues that the level of organizational arrangement is very important in determining the level of performance. Concisely, recognition and examination of health care facilities that express affirmative deviance offers a chance to characterize and propagate plans for improving quality. The study reaffirms the fact that the organizational performance solely depends on the management corporation on bringing about the change. Brodie, B. R., Gersh, B. J., Stuckey, T., Witzenbichler, B., Guagliumi, G., Peruga, J. Z., & ... Stone, G. W. (2010). When Is Door-to-Balloon Time Critical?: Analysis From the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) and CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty .. Journal of the American College of Cardiology (JACC), 56(5), 407-413. doi:10.1016/j.jacc.2010.04.020 con Brodie et al. (2010), confirm that DTB has a great impact on the patient’s mortality rate. From the study, as the patients stayed longer the higher the risk of death ensured. The research necessitates that the patients be triaged before treatment is initiated so that those with longer DTB time are dealt with. By doing so, the size of ischemia can be reduced. Cheskes, S., Turner, L., Foggett, R., Huiskamp, M., Popov, D., Thomson, S., & Verbeek, R. (2011). Paramedic contact to balloon in less than 90 minutes: a successful strategy for ST-segment elevation myocardial infarction bypass to primary percutaneous coronary intervention in a Canadian emergency medical system. Prehospital Emergency Care, 15(4), 490-498. Paramedic bypass of the protocols of emergency care reduced the number of minutes of the door to balloon time. From the study, there was an improvement of over 28 % percent. Before the initiation of paramedic by pass protocol, the average time taken by the patients was about 107 minutes. These saw an improvement of about thirty-seven minutes with an average time coming down to 70 percent. However, the study recommends for further studies to determine the outcome of those patients who were taken care of by these paramedics. Fitchett, D. H., Theroux, P., Brophy, J. M., Cantor, W. J., Cox, J. L., Gupta, M., & Goodman, S. G. (2011). Assessment and management of acute coronary syndromes (ACS): a Canadian perspective on current guideline-recommended treatment–part 2: ST-segment elevation myocardial infarction. Canadian Journal of Cardiology, 27(6), S402-S412. The vigorous study on the application of the recommended guidelines by the European society of cardiologists and American heart association brings out the various hiccups on the guidelines. As indicated in the study, it is evident that it has been an uphill task for hospitals in Canada to comply with the requirements. The points of weakness are highlighted giving the limelight on where to improve in order to meet the international requirements Hutchison, A. W., Malaiapan, Y., Jarvie, I., Barger, B., Watkins, E., Braitberg, G., ... & Meredith, I. T. (electrocardiogram(6), 528-534. The study confirms that using tele-electrocardiography and the emergency department have greatly reduced the door to balloon time. From the study, there was a great improvement on the door to balloon time upon implementation of the emergency department tele-electro cardiogram initially 44 percent of the patients achieved the recommended deadlines of management before the 90th minute. Nevertheless, with the inclusion of the tele-electrocardiogram, over 77 percent of the patients received the required care within the 90 minutes. Khare, R., Nannicelli, A., Powell, E., Seivert, N., Adams, J., & Holl, J. (2013). Use of risk assessment analysis by failure mode, effects, and criticality to reduce door-to- balloon time. Annals Of Emergency Medicine, 62(4), 388-398.e12. doi:10.1016/j.annemergmed.2013.01.023 Khare et al. (2013), studies the various phases of patient care in the process of door to balloon care of the patient. Concisely from the study, they confirm that there are about fifty-one failure points in the four phases of patient care. 58pecent of twelve hi risk failures occurred between cauterization laboratory activation and ECG. Further, the DTB time is much higher during the off hours than during on hours the difference. There is a difference of 22 minutes with patients taking an average of 55 minutes during on hours and 77 minutes during off hours. Le May, M. (2009). Code STEMI: implementation of a citywide program for rapid assessment and management of myocardial infarction. Canadian Medical Association Journal, 181(8), E136-E137. The time taken can be greatly reduced by allowing the bypass of the emergency department. The program allows the paramedics to perform the electrocardiogram while in the ambulance hence bypassing the emergency department. Furthermore, the program suggested that physicians should initiate the catheterization laboratory without necessary consulting the cardiologists. As the authors observed form the time of implementation of the program in 1st May 2005, there was a reduction of the door to balloon time form 69 minutes to about 123 minutes. The ever busy emergency department was also relieved hence had more time for the inpatients. Pitta, S. R., Myers, L. A., Bjerke, C. M., White, R. D., & Ting, H. H. (2010). Using Prehospital Electrocardiograms to Improve Door-to-Balloon Time for Transferred Patients With ST-Elevation Myocardial Infarction A Case of Extreme Performance. Circulation: Cardiovascular Quality and Outcomes, 3(1), 93-97. In his observation, the authors note that most of the time lost is on the acquisition of an electrocardiogram and most of the patients never had an electrocardiogram conducted on them because of delays. Hence, from the case study, the authors emphasize on the need to have a Prehospital electro cardiogram to conduct to aid in reducing the door to balloon time. Rathore, S. S., Curtis, J. P., Chen, J., Yongfei, W., Nallamothu, B. k., Epstein, A. J., & Krumholz, H. M. (2009). Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study. BMJ: British Medical Journal (Overseas & Retired Doctors Edition), 338(7706), 1312-1315. doi:10.1136/bmj.b1807 The authors observe that reduction of the door to balloon time has an impact on the mortality rate. From the study conducted, the mortality rate was as follows on the time taken to get the patient to balloon ( 30 minutes = 3 %, 60 minutes= 3.5% 90 minutes 4.3% 120 minutes = 5.6% 150 minutes = 7.0% 180 minutes = 8.4%) thus reduction of delay time from 90 minutes to 60 minutes saw a reduction in mortality rate by about 0.8 percent. Concisely delay in initiation of the percutaneous coronary intervention is associated with increased mortality rate among the affected patients. Terkelsen, C. (2014). Time to treatment-door-to-balloon time is not everything. Herz, Explanation of the international guidelines set to determine performance of the hospital on patient care is emphasized by the author. The article allays the confusion on the exact delay time before initiation of primary percutaneous catheter intervention and fibrinolysis. The paper calls for consensus on objectives when taking care of STEMI patients and demonstrates why it is not enough to just focus on the door to balloon time only. Willson, A. B., Mountain, D., Jeffers, J. M., Blanton, C. G., McQuillan, B. M., Hung, J., ... & Nguyen, M. C. (2010). Door-to-balloon times are reduced in ST-elevation myocardial infarction by emergency physician activation of the cardiac catheterization laboratory and immediate patient transfer. Med J Aust, 193(4), 207- 212 In the study conducted to assess the impact of interdepartmental collaboration on door to balloon time reduction, the authors observes that there is a great improvement on time reduction with emergency department physician activation of cardiac catheterization laboratory followed with instantaneous transfer in place. Collaboration of the necessary departments saw a reduction of the mean number of minutes taken to get the patient from door to balloon from 97 minutes to about 77 minutes. Median of door to activation time was reduced to 53 minutes from 63. Proportion of patients attended to within the first 90minutes also increased to 77 percent up from 41 percent. Read More

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