|
Cardiac ASA (aspirin)
Utilization
1. Define the process to be measured
1.1 Utilization of ASA by pre-hospital
personnel in patients with non-traumatic chest pain.
1.2 ASA utilization will be defined as…
1.2.1 Documentation of paramedic administration
of ASA
1.2.2 Documentation of patient self-administration
of ASA prior to the arrival of the paramedic.
1.2.3 In the event that a patient shows clearly
defined contraindications for the use of ASA, documentation of these contraindications
will constitute ASA utilization.
2. Measurement parameters
2.1 All Emergency Transports
2.2 Chief Complaint: “Chest Pain”, this
may also be indicated by “chest pressure”, “heart attack”, or any other
complaint that indicates a patient's suspicion or presentation that a cardiac
event is taking place.
2.3 The provider has a suspicion that a cardiac
event is taking place.
2.4 The administration of ASA will be measured
in each patient meeting the inclusion criteria.
2.5 The measurement will be focused on the provider's
compliance with protocols regarding the administration of ASA.
3. Data Verification
3.1 Data will be verified through the
retrospective review of Maine EMS run reports by the service chief or a
designated representative.
4. Defining Success/Failure
4.1 Successful compliance with the protocol
will be defined as clear documentation of ASA administration, the self-administration
of ASA prior to the arrival of the paramedic, or clearly documented contraindications
to the administration of ASA.
5. Frequency of Measurement
5.1 Data will be accumulated on
an ongoing basis.
5.2 Data will be reported to the sub-regional
QI coordinator when requested for the period requested.
6. Format for Reporting for Sub-Regional QI
Coordinators
6.1 Round calculations of compliance
percentages to the nearest whole number.
6.2 Report the (1) the license number of
the service participating, (2) total number of calls meeting the
inclusion criteria, (3) the total number of calls determined to be successful,
and (4) the percentage of success.
6.3 Reports per sub-region should conform
to the following reporting format.
Service License Number Total Calls Included in
Study Total Calls Demonstrating Compliance Percentage of Compliance Comments
7. Standard of Care/Compliance Threshold
7.1 The minimum standard for compliance
will be 80%.
top
Aspirin
in Cardiac | ECG Documentation | Glucometer
Use | Pain Management
Spinal
Assessment
ECG Documentation
1. Define the process to be measured
1.1 Inclusion of ECG strips with charts
prepared by pre-hospital personnel in patients with a documented ECG interpretation
and/or monitor usage.
1.2 ECG strip inclusion will be defined as…
1.2.1 The EMS provider supplying to the
data collector, copies of a separate form, that has attached, all ECG strips
recorded on the transport.
1.2.2 The form for attaching the ECG strips may
be commercially prepared or developed for use by the individual service
or hospital but must clearly reference a MEMS run report through the inclusion
of the date of the chart, MEMS run report number, patient's name, and patient's
date of birth (see attached example).
2. Measurement parameters
2.1 All Transports to the Emergency Department.
2.2 Transports that document monitor utilization
and/or an ECG interpretation.
2.3 Transports where the EMS provider has supplied
an appropriate ECG documentation form to the data collector.
3. Data Verification
3.1 Data will be verified through the
retrospective review of Maine EMS run reports and ECG documentation forms
by the service director or a designated representative.
4. Defining Success/Failure
4.1 Successful compliance with the study
parameters will be defined as the provision, by the EMS provider, of a
photocopy of a separate form that provides a representation of the ECG
strip and includes data elements that allow for the correlation between
the form and a Maine EMS run report.
5. Frequency of Measurement
5.1 Data will be accumulated on an ongoing
basis.
5.2 Data will be reported to the sub-regional
QI coordinator when requested for the period requested.
6. Format for Reporting for Sub-Regional QI
Coordinators
6.1 Round calculations of compliance
percentages to the nearest whole number.
6.2 Report the (1) the license number of the
service participating, (2) total number of calls meeting the inclusion
criteria, (3) the total number of calls determined to be successful, and
(4) the percentage of success.
6.3 Reports per sub-region should conform to
the following reporting format.
Service License Number Total Calls Included in
Study Total Calls Demonstrating Compliance Percentage of Compliance Comments
7. Standard of Care/Compliance Threshold
7.1 The minimum standard for compliance
will be 80%.
top
Aspirin
in Cardiac | ECG Documentation | Glucometer
Use | Pain Management
Spinal
Assessment
Glucometer Use in Altered Mental Status Patients
1. Define the process to be measured
1.1 Measurement of blood glucose levels
in patients with altered mental status.
1.2 Glucose measurement will be defined as…
1.2.1 The documentation of the use or
attempted use of a blood glucose measurement process.
2. Measurement parameters
2.1 All Transports to the Emergency Department.
2.2 Documentation that indicates that the patient
is experiencing some type of altered mental status.
2.2.1 This may include, but is not limited
to complaints or descriptions using the words unresponsive, lethargy, confusion,
aphasia, dementia, and paresis, or
2.2.2 A Glasgow Coma Scale score less than 15.
2.3 The documentation of blood glucose measurement
will be evaluated in each patient meeting the inclusion criteria.
2.4 The evaluation will be focused on the provider's
compliance with protocols regarding the determination of blood glucose
levels.
3. Data Verification
3.1 Data will be verified through the
retrospective review of Maine EMS run reports by the service director or
a designated representative.
4. Defining Success/Failure
4.1 Successful compliance with the study
parameters will be defined as documentation, by the EMS provider, of the
measurement or attempted measurement of blood glucose level.
5. Frequency of Measurement
5.1 Data will be accumulated on an ongoing
basis.
5.2 Data will be reported to the sub-regional
QI coordinator when requested for the period requested.
6. Format for Reporting by Sub-Regional QI
Coordinators
6.1 Round calculations of compliance
percentages to the nearest whole number.
6.2 Report the (1) the license number of the
service participating, (2) total number of calls meeting the inclusion
criteria, (3) the total number of calls determined to be successful, and
(4) the percentage of success.
7. Standard of Care/Compliance Threshold
7.1 The minimum standard for compliance
will be 80%.
top
Aspirin
in Cardiac | ECG Documentation
| Glucometer Use | Pain Management
Spinal
Assessment
Pain Management
1. Define the process to be measured
1.1 The prehospital management of pain
for patients with suspected traumatic injuries to the extremities and associated
complaints of pain.
1.2 The prehospital management of pain will be
defined as…
1.2.1 Documentation of the consideration
of patient needs with regard to the presence of pain, the intensity of
pain, and the need for the use of pain management techniques.
1.2.2 Documentation of the use of pain management
techniques for patients with suspected traumatic injuries to the extremities.
1.3 Pain management techniques will be defined as
the use of fixation devices (splints) to prevent movement, the application
of cold, and/or the administration and/or medical control request of narcotic
analgesics.
1.4 Extremities will be defined as the arms,
from the shoulder girdle to the phlanges, and the legs, from the hip to
the phlanges.
2. Measurement parameters
2.1 All Transports to the Emergency Department.
2.2 Transports that document traumatic injuries
to the extremities.
2.3 Transports where the patient has a complaint
of pain secondary to the traumatic injuries.
3. Data Verification
3.1 Data will be verified through the
retrospective review of Maine EMS run reports and ECG documentation forms
by the service director or a designated representative.
4. Defining Success/Failure
4.1 Successful compliance with the study
parameters will be defined as the documentation of an assessment of the
patient's needs for pain management and the use of pain management techniques.
5. Frequency of Measurement
5.1 Data will be accumulated on an ongoing
basis.
5.2 Data will be reported to the sub-regional
QI coordinator when requested for the period requested.
6. Format for Reporting for Sub-Regional QI
Coordinators
6.1 Round calculations of compliance
percentages to the nearest whole number.
6.2 Report the (1) the license number of the
service participating, (2) total number of calls meeting the inclusion
criteria, (3) the total number of calls determined to be successful, and
(4) the percentage of success.
6.3 Reports per sub-region should conform to
the following reporting format.
Service License Number Total Calls Included in
Study Total Calls Demonstrating Compliance Percentage of Compliance Comments
7. Standard of Care/Compliance Threshold
7.1 The minimum standard for compliance
will be 80%.
top
Aspirin
in Cardiac | ECG Documentation
| Glucometer Use | Pain Management
Spinal
Assessment
Patient Refusals
1. Define the process to be measured
1.1 Accurate identification of patients
capable of exercising their right to refuse treatment or transport, to
include…
1.1.1 Adult patients that are fully oriented
to person, place, and time;
1.1.2 Emancipated minor patients that are fully
oriented to person, place, and time;
1.1.3 Patients that have not expressed suicidal
ideation;
1.1.4 Individuals that are identified by their
obvious condition;
1.1.5 Individuals that identify themselves as
a patient or are identified by another individual at the scene as being
ill, injured, or requiring evaluation.
1.2 Appropriate documentation of patient refusals,
to include…
1.2.1 Documentation of the treatment
offered;
1.2.2 Documentation of the patient's statement
of refusal;
1.2.3 Documentation that the patient was informed
of the risks of refusal and benefits of treatment.
1.2.4 Documentation of the patient's reason for
refusal.
1.2.5 Documentation of the patient's signature
or a statement that the patient refused to sign.
2. Measurement parameters
2.1 All ambulance or first responder
service responses where a patient is identified and the patient refuses
treatment or transport.
3. Data Verification
3.1 Data will be verified through the
retrospective review of Maine EMS run reports by the service director or
a designated representative.
4. Defining Success/Failure
4.1 Successful compliance with the study
parameters will be defined as the documentation of…
4.1.1 Accurate identification of patients
capable of making informed decisions about their own care.
4.1.2 Complete documentation of the patient's
refusal including the elements outlined in 1.2.1 - 1.2.6.
5. Frequency of Measurement
5.1 Data will be accumulated on an ongoing
basis.
5.2 Data will be reported to the sub-regional
QI coordinator when requested for the period requested.
6. Format for Reporting for Sub-Regional QI
Coordinators
6.1 Round calculations of compliance
percentages to the nearest whole number.
6.2 Report the (1) the license number of the
service participating, (2) total number of calls meeting the inclusion
criteria, (3) the total number of calls determined to be successful, and
(4) the percentage of success.
6.3 Reports per sub-region should conform to
the following reporting format.
Service License Number Total Calls Included in
Study Total Calls w/ Accurate Identification Percentage of Accurate Identification
Total Calls w/ Complete Documentation Percentage of Complete Documentation
Comments
7. Standard of Care/Compliance Threshold
7.1 The minimum standard for compliance
will be 80%.
top
Aspirin
in Cardiac | ECG Documentation
| Glucometer Use | Pain Management
Spinal
Assessment
Spinal Assessment
1. Define the process to be measured
1.1 Appropriate spinal assessment and
treatment of patients involved in incidents with a positive mechanism of
injury (blunt trauma, vehicular crashes, falls greater than 3 feet, or
falls of adults from a standing height).
1.2 Appropriate spinal assessment and
treatment will be defined as…
1.2.1 The application of spinal stabilization
devices according to the established standard of care, or
1.2.2 The documentation of the appropriate use
of the Maine EMS Spinal Assessment Protocol, including the documentation
of the assessment required to utilize the protocol. This documentation
must include…
1.2.2.1 An assessment of the patients
reliability in reporting pain, deficits, and the history of the incident.
1.2.2.2 The absence of distracting injuries
1.2.2.3 The presence of normal sensory-motor
function on assessment.
1.2.2.4 The absence of spine pain or tenderness.
2. Measurement parameters
2.1 All Transports to the Emergency Department.
2.2 Transports that document blunt trauma, vehicular
crashes, falls greater than 3 feet, or falls of adults from a standing
height.
3. Data Verification
3.1 Data will be verified through the
retrospective review of Maine EMS run reports by the service director or
a designated representative.
4. Defining Success/Failure
4.1 Successful compliance with the study
parameters will be defined as the documentation of appropriate spinal stabilization
or appropriate application of the Maine EMS Spinal Assessment Protocol
as defined above.
5. Frequency of Measurement
5.1 Data will be accumulated on an ongoing
basis.
5.2 Data will be reported to the sub-regional
QI coordinator when requested for the period requested.
6. Format for Reporting for Sub-Regional QI
Coordinators
6.1 Round calculations of compliance
percentages to the nearest whole number.
6.2 Report the (1) the license number of the
service participating, (2) total number of calls meeting the inclusion
criteria, (3) the total number of calls determined to be successful, and
(4) the percentage of success.
6.3 Reports per sub-region should conform to
the following reporting format.
Service License Number Total Calls Included in
Study Total Calls Demonstrating Compliance Percentage of Compliance Comments
7. Standard of Care/Compliance Threshold
7.1 The minimum standard for compliance
will be 80%.
top
Aspirin
in Cardiac | ECG Documentation | Glucometer
Use | Pain Management Spinal
Assessment
|
