Date of Award

Summer 2022

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Faculty Chair

Amanda Bullard

Abstract

Background: Cardiac biomarkers are used for the diagnosis and risk stratification of patients with chest pain and suspected acute coronary syndrome (ACS) (Kamal, 2021). Cardiac troponin is the only biomarker recommended to be used for the diagnosis of acute myocardial infarction (AMI) at this time due to its superior sensitivity and accuracy (Kamal, 2021). Emergency departments routinely provide care for patients presenting with chest pain symptoms and should be prepared to utilize evidence-based guidelines for troponin trending to effectively evaluate these patients.

Purpose: The purpose of the DNP project was to improve emergency department healthcare provider compliance to evidence-based high-sensitivity troponin trending guidelines in patients admitted to the hospital with chest pain as the primary diagnosis.

Methods: This quality improvement project involved the implementation of a troponin trending toolkit consisting of an educational in-service and the creation of a new electronic chest pain panel.

Results: Key results include statistically significant improvement in healthcare provider adherence to evidence-based troponin trending guidelines, (p=0.0451). Numerical increases were also noted. Pre-intervention chart review revealed 58% adherence and the post-intervention chart review revealed 100% adherence to evidence-based troponin trending guidelines.

Conclusion: This project emphasized the importance of hospitals implementing a standardized program for improving compliance with evidence-based standards. The troponin trending toolkit was effective at improving emergency department healthcare provider compliance with evidence-based troponin trending guidelines for patients admitted to the hospital with chest pain as the primary diagnosis.

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Defense Approval

Included in

Nursing Commons

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