Reduction of Erroneous ST-segment Elevation Myocardial Infarction Diagnoses: A Successful Nurse-led Quality Improvement Project.
Publication/Presentation Date
12-10-2025
Abstract
An ST-segment elevation myocardial infarction is a life-threatening condition within the spectrum of acute coronary syndrome, with well-recognized implications for short-term and long-term health outcomes. Retrospective review of our institutional electronic health records identified patterns of inaccurate acute coronary syndrome diagnostic assignment, including the presence of erroneous ST-segment elevation myocardial infarction diagnoses in discharge records. Such erroneous diagnoses in the durable health record may increase risk to patients through inadequate risk assessment and inappropriate follow-up care. Misapplication of a shortcut in our electronic health record system for rapidly ordering emergent cases was identified as a potential cause of the quality gap. To address this issue, a nurse-led quality improvement project was developed by using the define, measure, analyze, improve, and control framework. The project intervention decreased the percentage of patients with erroneous diagnoses from 24% to 7% and marginally improved nursing staff satisfaction. Our project successfully addressed an institutional quality concern. Our goal of reducing erroneous discharge diagnoses with minimal disruption to our existing practice was achieved, positively affecting our patients. Including both nurse leaders and frontline health care workers ensured the success of our project.
ISSN
1550-5103
Published In/Presented At
Porter, J., Klassen, A. B., Chesney, J. A., Wilson, M. J., Eastman, S. C., Fatema, K., Connelly, R. A., Konz, B. A., Bartelt, J. M., Ring, M. T., Winkel, D. B., Churchill, J. T., Griffin, D. M., Brady, B. J., Bartelt, J. D., Johnson, M. P., Gulati, R., Wiley, B., Bennett, C., & Barsness, G. W. (2025). Reduction of Erroneous ST-segment Elevation Myocardial Infarction Diagnoses: A Successful Nurse-led Quality Improvement Project. Nursing administration quarterly, 10.1097/CIN.0000000000001379. Advance online publication. https://doi.org/10.1097/CIN.0000000000001379
Disciplines
Medicine and Health Sciences
PubMedID
41371987
Department(s)
Department of Medicine, Cardiology Division
Document Type
Article