Date of Graduation

4-2021

Document Type

Capstone

Keywords

Percutaneous coronary intervention; Same day discharge; Access to cardiovascular care

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level

Graduate

Advisor/Mentor

Stewart, Angela R.

Committee Member

Kilmer, Michele

Second Committee Member

Cartwright, Angela

Third Committee Member

Bledsoe, Bill

Abstract

High rates of Cardiovascular disease (CVD) and ischemic heart disease (IHD) have led to ever-increasing numbers of percutaneous coronary interventions (PCI) performed. The prevalence of IHD and subsequent PCI has been found to limit bed availability and access to cardiovascular care. Historically, the standard of care following elective PCI has included overnight observation (OO) though clinical advances to PCI procedures have made it possible for same day discharge (SDD) following elective PCI. There are many benefits of SDD following elective PCI that include increased access to cardiovascular care, hospital cost savings, and patient satisfaction without compromising patient safety. The DNP project took place at an inpatient facility in Pulaski County, Arkansas where practice most often included OO following elective PCI. The purpose of the project was to increase access to cardiovascular care through the creation and implementation of a SDD protocol following elective PCI. The overall project aim was to increase the percentage of SDD to 50% by March 31, 2021. The project did not meet this goal as implementation failed during the planned implementation period at the clinical site due to the lack of physician engagement. Despite the lack of SDD protocol implementation, data from the 10-week collection period was analyzed to describe baseline data and current practices at the clinical site. During the 10-week collection period, 20 of 55 patients, or 36.36%, were discharged via other non-established SDD methods. The SDD protocol is still projected to become the standard of practice at the clinical site after future implementation.

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