According to the United States Centers for Disease Control and Prevention, chest pain is among the most common reason for an emergency room visit. Chest pain patients represent almost 29 % of the current observation patient population at the largest community hospital in Lancaster, Pennsylvania and characterize the number one diagnosis among all patients placed in observation status. Nurse practitioners manage the observation patients in collaboration with the hospitalist group at this community hospital. Identifying which of these patients truly represent the low risk chest pain population and understanding how to best medically manage them is essential to saving lives. Using a risk stratification tool and completing a review of the evidence guiding the diagnostic work-up of this patient population, a nurse practitioner group sought to develop a comprehensive algorithm to consistently direct care of the low risk chest pain patient with consideration to length of stay, patient charges and major adverse cardiac events post observation stay. Offered is the research and synthesis of the evidence that guided the development, implementation and dissemination of the algorithm for management of the low risk chest pain population using a nurse practitioner model.
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