Utility of Daily Troponin Orders for Identifying Acute Myocardial Infarction Patients for Quality Improvement
| Autor: | Lisa Gronski, Jason Ryan, Wendy Martinson, Kanwar P. Singh |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Quality management Myocardial Infarction Hospital population medicine Humans cardiovascular diseases Myocardial infarction Intensive care medicine health care economics and organizations Aged biology business.industry Guideline adherence Clinical course American Heart Association medicine.disease Quality Improvement Troponin Hospitals United States Practice Guidelines as Topic Emergency medicine biology.protein Female Guideline Adherence Myocardial infarction diagnosis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine. 11:74-76 |
| ISSN: | 1535-282X |
| Popis: | Background Previous studies have demonstrated low rates of adherence to American College of Cardiology (ACC) and American Heart Association (AHA) guidelines for acute myocardial infarction (AMI). Quality improvement projects increase compliance with recommended therapies, but identification of AMI patients is a major challenge. Objective To determine the utility of a daily troponin list in identifying AMI patients for a quality improvement initiative to increase compliance with ACC/AHA-recommended therapies. Design Quality improvement initiative. Methods and results During a 3-month period, the charts of patients with elevated troponin levels were screened for a diagnosis of AMI. For those patients with AMI, a clinical reminder about ACC/AHA-recommended therapies was placed in the chart. Nearly half (46%) of our hospital population had a troponin level measured during their clinical course. Of these, 26% had elevated troponin levels and 5% had AMI. All patients with AMI were identified using the daily troponin list with a sensitivity of 100% and a specificity of 78.4%. The daily troponin list captured more AMI patients than the admitting diagnosis. Use of the daily troponin list and targeted clinical reminders was associated with maintenance of a high (>95%) compliance with recommended therapies. Conclusions A daily list of inpatients with a positive troponin identified all patients with AMI. Targeted reminders to clinicians regarding ACC/AHA-recommended therapies for AMI were associated with consistent adherence to guideline-recommended therapies. |
| Databáze: | OpenAIRE |
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