Nurse Co-ordinated Rapid Access Chest Pain

Clinic

The Belfast City Hospital Experience

Str Helen Greene

Clinical Nurse Specialist

Coronary heart disease is the most common cause of death in the UK, with around one in five men and one in seven women dying from

the disease.

It is also the most common cause of premature death (<75yrs), accounting for 19% of men and

10% of women.

Allender. S et al 2008 . Coronary heart disease statistics. British Heart Foundation, London

Guidelines

The Rapid Access Chest Pain Clinic was initially

set up as a response to the National Service

Framework guidelines for Coronary Heart

Disease (2000). As a means of improving the patients experience.

► The RACPC was first opened in 2002.

► To date Approximately 9000 patients have been seen.

► Average 1000 patients per year.

Patients are referred from GPs.

► Presenting with symptoms suggestive of coronary artery disease (CAD)

♦ No previous history of CAD

♦ Previous history of CAD with worsening symptoms.

The patient experience:

►Blood samples

►Clinical history

►Physical examination

►ECG, BP

►Exercise stress testing (EST)

►Results and management plan (inc meds)

EST outcomes

9%

78%

13%

Positive Negative Equivocal

Coronary Angiography Outcomes

23%

51%

20%6%

CABG PCI MED Mx NCAPCI : Stent insertion

CABG : Coronary artery bypass grafting

Med Mx: Medical management

NCA: Normal coronary arteries

Satisfaction surveys:

GP and Patient satisfaction surveys every

2 years.

GP’s - 100% very satisfied with the service.

Patients – 100% very satisfied.

Conclusion:Key word is Rapid

►Rapid appointment allocation

►Patient results on the day

►Rapid referral for further investigation (therefore reducing waiting times)

►Commencement of medication by nurse prescriber

►GP results within 24 hours

Questions?