Date

Fall 2023

Document Type

Scholarly Project

Department

College of Nursing

Abstract

Problem Statement: ST-elevated myocardial infarction (STEMI) is one of the leading causes of cardiogenic shock (CS) associated with increased in-hospital mortality. Despite multiple efforts to improve outcomes, mortality remains high.

Purpose: This quality improvement project aimed to analyze the impact of a cardiogenic shock algorithm on survival to discharge for STEMI patients.

Methods: A CS algorithm was implemented at a cardiac catheterization laboratory on October 3, 2022. Using the Plan-Do-Study-Act quality improvement framework, data was retrospectively collected on patients presenting with a STEMI who meet CS criteria to determine if there was improved survival to discharge after implementing the algorithm. Historical comparisons were made with patients who presented prior to the implementation period to determine if there was a difference in survival pre- and post-implementation.

Inclusion/Exclusion Criteria: All patients ≥18 diagnosed with STEMI and proceeded to the cardiac catheterization laboratory were included in the chart review. Only those who met CS criteria were included in the data analysis. Patients who had a do-not-resuscitate order at the time of the STEMI or did not advance to the cardiac cath lab were excluded.

Analysis: Continuous variables are summarized using means and standard deviation; unpaired t-tests were used to compare the pre- and post-implementation samples. Fisher's exact test was performed to determine if there was a significant difference in survival to discharge in the pre- and post-implementation periods.

Implications for Practice: It is hypothesized that following the implementation and utilization of a standardized CS algorithm, there will be an increase in survival to discharge for patients in CS.

Rights

© 2023, Alana E Hall

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