Date of Paper/Work

5-2018

Type of Paper/Work

Systems Change Project

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Gwen Short

Abstract

Despite symptom assessment serving as one of the primary aspects of management for atrial fibrillation, no standardized instrument for documenting symptoms exists. The purpose of this project is to further assess the utility of the Canadian Cardiovascular Society Severity of Atrial Fibrillation (CCS-SAF) scale within the subspecialty of electrophysiology at the Minneapolis Heart Institute. The target population is physicians, nurse practitioners, and physician assistants within the subspecialty electrophysiology evaluating patients in the clinic setting. Before scale implementation, dissemination of information regarding the scale occurred through an educational session and pre-implementation survey. Following an implementation period of six weeks, a post-implementation survey was completed to identify the value of a symptom severity scale. Participation in the post-implementation survey was 54%. The CCS-SAF scale improved communication and assisted with assessing response to therapy; however, utility of the scale for treatment decisions was equivocal. A significant factor limiting integration of the scale into documentation was the absence of an automated process. Based on these findings, creation of a system-wide SmartText is occurring to enhance scale use. With consistent use, the goal is the scale will permeate not only the subspecialty of electrophysiology but general cardiology, additional cardiovascular subspecialties, internal medicine, and family practice as well. Through ongoing use of the scale, there will be less variation in the assessment of atrial fibrillation, and further data to assess utility in the clinical setting.

Available for download on Friday, May 15, 2020

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