No abstract

Approximately 5% of all emergency department (ED) visits require evaluation of chest pain and atypical symptoms for diagnosis or exclusion of myocardial infarction or acute coronary syndrome (ACS) (P. Rui, K. Kang, & J. J. Ashman, 2016). Health care providers rely on effective tests and assessment protocols for definitive diagnosis of ACS. Cardiac biomarkers in troponin T assays enable rapid exclusion of ACS. This project compared high-sensitivity troponin T assay to conventional troponin T assay in reducing unnecessary stress tests for ACS exclusion, length of stay in the ED, and rate of readmissions within 30 days after ACS exclusion and discharge. A retrospective review of 300 medical records for exclusion of ACS compared 150 patients receiving conventional troponin T assay and 150 patients receiving high-sensitivity troponin T assay. The mean length of stay in the preintervention group was 8.3 hr (SD = 1.60) compared with 3.9 hr (SD = 1.56) in the postintervention group (t (298) = 24.56, p < 0.001). A significant difference was found in necessary and unnecessary stress testing (X 2 (1) =17.42, p < 0.05). The preintervention group had significantly more normal stress tests and the postintervention group had significantly more abnormal stress tests. In the preintervention group, 4 (2.7%) patients were readmitted within 30 days with ACS; no readmissions were reported for the postintervention group. Findings supported outcome improvements with the high-sensitivity troponin T assay. Using high-sensitivity troponin T assay in the diagnosis protocol can improve length of stay for patients with exclusion of ACS and reduce unnecessary stress tests during the ED stay.

No abstract

Nursing program quality is measured by first time National Council Licensure Examination-Registered Nurse (NCLEX-RN) pass rates. Therefore, many schools of nursing have implemented aggressive prediction and remediation measures to improve first time NCLEX-RN pass rate success. The purpose of this retrospective study was to determine predictors of success or failure on the NCLEX-RN for graduates of a Southeastern, Baccalaureate nursing program. Data was examined from academic records of students who completed Baccalaureate School of Nursing (BSN) program of study from Spring 2007 to Fall 2011. Results of the study reveal the importance of early identification of at risk students. Early identification allows for the implementation of strategies to aid in promoting student success on NCLEX-RN. These strategies include tutoring, state board review courses, study skills classes, time management classes and practice questions.