A Collaboration to Improve Low Compliance in the Utilization of Risk Score for NSTEMI Patients

Speaker:
Ravi Diwan MD, FACC, FSCAI - Interventional Cardiology, Shore Heart Group
Stephanie Minerva, MSN - Nurse Manager, Hackensack Meridian Riverview Medical Center
Jessica Altschuler, BSN - Assistant Nurse Manager, Hackensack Meridian Riverview Medical Center
Elvira Baquerizo, MSN, MBA, APN, CCRN, NP-C - Care Transformation APN, Hackensack Meridian Riverview Medical Center

Description:
Utilization of validated risk scores can provide an objective stratification approach towards the identification of non-ST segment Myocardial Infarction (NSTEMI) patients who can be candidates for early (within 12-24 hours) or delayed (within 24-72 hours) invasive strategy management. Early invasive strategy for the high risk NSTEMI patients have shown reduced mortality and improved outcomes (Butt, et al., 2021). After reviewing the National Cardiovascular Registry (NCDR®) Chest Pain - MI Registry™ data, metric # 50 that addresses risk score stratification for NSTEMI patients showed a continued decline in compliance and is below the 50th percentile. Furthermore, metric#51 that reports the percentage of high risk NSTEMI patients who received an invasive strategy in less than 24 hours of arrival, had no data to show. Absence of the data does not reflect that Riverview Medical Center (RMC) did not treat high risk NSTEMI patients. Improved compliance to metric #50 will aid in identifying these patients and metric #51 will allow RMC to evaluate its performance and how optimal the timing of the invasive procedure was done.

• Identify high risk NSTEMI patients for early invasive strategy.
• Prioritize patients for early coronary angiography and revascularization.
• Identify initiatives that promote utilization of risk scores for NSTEMI.