Date of Graduation

Summer 8-11-2017

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


The goal of this project is to implement a chest pain protocol order set in order to increase the nurse-initiated chest pain protocol by 50%. The project was implemented in a Emergency Department (ED) that has problems with understaffing and patient crowding. RN-initiated chest pain orders are implemented 11% of the time and 89% by physicians. RNs initiated orders in less than 10 minutes while 50% of physician orders are initiated over 30 minutes. This results in delayed care and decreases patient flow. A chest pain protocol order set was designed based on the approved nursing protocol policy. 90% of nurses received training and the protocol was implemented in the ED. Following implementation, the nurse-initiated chest pain protocol increased from 11% to 30%. The physician-initiated orders decreased from 89% to 70%. Nurses initiated orders in less than 10 minutes. The project exceeded the 22% target outcome and nurses felt more confident when placing orders with the chest pain protocol order set. The continuation of this project will improve patient outcomes and patient flow. Integrating the chest pain protocol into the Computerized Patient Record System (CPRS) will allow nurses to place orders more efficiently.