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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?