Date
2-28-2025
Department
School of Nursing
Degree
Doctor of Nursing Practice (DNP)
Chair
Shade Adigun
Keywords
chest pain, acute coronary syndrome (ACS), urgent care, primary care, Marburg Heart Score, risk prediction tool, door-to-EKG times, outpatient evaluation of coronary artery disease (CAD), chest pain clinical pathways
Disciplines
Medicine and Health Sciences | Nursing
Recommended Citation
Jones, Tysheena L., "The Clinical Impact of a Standardized Pathway for Chest Pain Evaluation in the Urgent Care Setting" (2025). Doctoral Dissertations and Projects. 6533.
https://digitalcommons.liberty.edu/doctoral/6533
Abstract
This study aimed to evaluate the deficiencies in the current chest pain evaluation practices compared to standard of practice at urgent care centers and to develop an evidence-based clinical workflow prioritizing the reduction of the door-to-EKG times utilizing the Marburg heart score assessment tool. Conducted in three urgent care centers within a larger not-for-profit healthcare system, the retrospective pretest-posttest design involved 44 patients presenting with chest pain. Utilizing t-tests, the study found a significant reduction in door-to-EKG times from 39 minutes pre-intervention to 14 minutes post-intervention (p < 0.05). The pre implementation chart reviews revealed that 7 (32%) of the charts had the required risk assessment tool used, and score documented in the EMR. The post implementation chart reviews revealed that 6 (27%) of the charts had the required risk assessment tool used and score for chest pain documented in the EMR. The Marburg Heart Score facilitated timely identification of high-risk patients while minimizing unnecessary EKGs for low-risk individuals, though protocol adherence and external workflow disruptions were noted limitations. The findings underscore the importance of standardized workflows in enhancing care efficiency and patient outcomes, suggesting that future research explore long-term sustainability and broader implementation in urgent care settings.
