10.25419/RCSI.12698216
Reginald Imasuen
Improving the utilisation and the awareness of high-sensitivity cardiac troponin test
<p>Cardiac troponin is one of the biomarkers to diagnose a
myocardial infarction and has been in use for many years. There has been many
improvements in these biomarkers to aid in the diagnosis of a myocardial
infarction. An improvement in troponin sensitivity to be specific. Each new
generation of troponin has led to improved diagnostic sensitivity. The new
generation of troponin are known as the high-sensitivity troponin. The
advantage of the high-sensitivity troponin is the earlier detection of
myocardial injury which can lead to a diagnosis of an infarction. However, with
a higher sensitivity, comes a lower specificity. Non-cardiac aetiologies can
also precipitate an elevation of troponin. Therefore, it is vital that the
troponin test is used in an appropriate context or clinicians will face a risk
of misinterpreting the results of elevated troponin which may lead to further
invasive investigations. This Quality Improvement Plan (QIP) focuses on
improving the utilisation and the awareness of the high-sensitivity troponin
test. The intent of the QIP is to highlight the potential impact on patients
should the troponin test not be utilised properly. Adopting specific QI tools
including a driver diagram, the causes for improper utilisation of the troponin
test are highlighted. The data collected include patient consults, cardiac
MRI’s and coronary angiograms. A 2% increase is observed in coronary
angiograms, an 18.5% and 4.1% increase in cardiology consults are observed in
two consultant patient groups. No increase in cardiac MRI’s. Implementing a
regular grand round presentation to medical practitioners, placing informative
notices at nurse stations as well as implementing a biochemistry result reminding
tool will be key to optimise medical practice, resulting in better patient centred
care.</p>
Cardiology
Royal College of Surgeons in Ireland
2020
2020-07-23
2020-07-23
Thesis
2435348 Bytes
CC BY-NC-SA 4.0