Assessment and intervention for ischemic chest pain: a case study with legal implications for nursing practice

In order to reduce early and long-term mortality and morbidity from myocardial infarction, nurses must promptly and thoroughly assess chest pain, intervene quickly and evaluate the results of the interventions. In Kielley v. General Hospital Corp. et al, a patient suffered a massive heart attack while under observation on a cardiology unit. The court held the hospital liable for the nurses' breach of its chest pain protocol and for failing to have electrocardiograms done when the patient experienced pain. The case clearly illustrates the harm a patient may incur when nurses fail to properly assess and intervene. It reinforces the importance of adherence to hospital protocols that have been put in place to ensure patient safety.