Monday, November 5, 2007

This presentation is part of : Leadership in Healthcare Organizations
APNs in Acute Cardiac Care: Improving Outcomes
Patti McCluskey-Andre, RN, MSN, CCNS, ACNP-C, Cardiac Surgery Department, Hoag Memorial Hospital, Newport Beach, CA, USA and Margaret A. Morley, RN, MSN, CNS/ANP-C, Hoag Hospital, Newport Beach, CA, USA.
Learning Objective #1: identify the impact an advanced practice nurse can have within a cardiovascular program's adherence to evidence based practice
Learning Objective #2: discuss development of standardized tools within a program to impact data outcome and promote consistency, ease and accuracy

Heart disease continues to be a leading cause of death and disability in the United States. Although great progress has been made in research and treatment, there continues to be disparities in care and adherence to guidelines and recommendations. In the 21st century, hospitals are challenged by emerging pay for performance, quality and safety measures, and public reporting of performance. There are mandatory state, JCAHO, government and insurance reporting with multiple levels of data abstraction and reporting. The advanced practice nurse is well positioned to design and initiate programs to assure best practice and impact their facilities scorecards positively in multiple arenas. A cardiovascular program, seemingly the most measured and watched in a facility due to changes in the population, reimbursement and technology has many measures to define quality of care. This session will examine the impact of nurse practitioners and clinical nurse specialists as the driving force of evidence based practice in our CV program.  By collection of data for multiple guidelines, initiatives and measures in CHF, CV surgery and coronary artery disease we were are able to identify opportunities for improvement in our program. By developing multiple standardized tools across the service including order sets, discharge progress templates, transfer and follow up forms with triggers and contraindication reminders, we are able to have a direct impact on our data and promote ease, consistency and accuracy. Staff nurses are required to be active and proactive participants as well. Our road to success is not only through support and education of providers but nursing staff and most importantly patients. Our goal is to promote the highest quality of care and prevention for our patients with the side effect of top performance.