Graduation Semester and Year

Fall 2024

Language

English

Document Type

Thesis

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Tiffany Trent, DNP

Abstract

Abstract

Purpose

Left Ventricular Assist Device (LVAD) is a high-risk, low-volume patient population with admission rates of up to 72%. The purpose of this study was to provide a care bundle to increase the knowledge of the emergency department (ED) staff and decrease the door to consult times to the advanced heart failure (AHF) team for LVAD patients presenting to the ED at a level I trauma center in Texas.

Methods

In collaboration with emergency clinical staff, the project team implemented a bundle that included a pathway for the LVAD patients upon presentation to the ED, targeted education for clinical staff with pre- and post-education survey, and transportation checklist for cases of admission. Data were collected and analyzed using Statistical Analysis System (SAS) Statistics, which summarized the descriptive statistics.

Results

Ordinal logistic regression analysis revealed significant improvement in questionnaire scores for Q1 (Confidence) (P = <.001; ROC = 68.3%), Q3 (Identifying alarms) (P = <.0001; ROC = 69.6%), and Q4 (Where to find educational resources) (P = <.001; ROC = 66.3%) on post-education. ANCOVA analysis revealed the bundle approach significantly reduced door to consult time (DTC), with consultation used as a covariate (P = .006). DTC decreased from 245min to 35 min using the bundle.

Discussion

A bundled care approach to the LVAD patient in the ED enhances the care of the patient by decreasing DTC and increasing the knowledge of the staff in this patient population. Continued efforts aimed at caring for this population are needed to bring awareness and enhance

safety for these patients.

Keywords

Left Ventricular Assist Devices, Emergency Department, Heart Failure, Education

Disciplines

Critical Care Nursing | Interprofessional Education | Other Nursing

Comments

Acknowledgements: Tiffany Trent, DNP Angela Gentry, DNP Anam Amed, MSc, PhD

Available for download on Saturday, May 31, 2025

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