Date of Conferral



Doctor of Nursing Practice (DNP)




Mirella Brooks


It is common for clinicians to implant medical devices, such as permanent pacemakers and implantable defibrillators, for cardiac diseases. These medical devices require follow-up care at regular intervals to ensure proper device function and optimal outcomes. Currently, many individuals without insurance or financial resources lack access to recommended follow-up care after implantation of a cardiac device. The purpose of this project was to determine the number of individuals who have had a medical device implanted without insurance coverage over a 3-year period, and then to establish a clinic that provides this service. The standard of care and operating procedure for the pacemaker clinic was established using evidence-based guidelines from the Heart Rhythm Society and the American Heart Association. Complexity science was the theoretical model used to guide this project's design and implementation. This quality improvement initiative was non-experimental, descriptive, and quantitative. Data were extracted from the ICD Registry and United States Census Bureau to determine the number of residents, insurance status, and number of implants over a 3-year period. These data were used to estimate the number of individuals with devices. The data revealed that 40 individuals with low power cardiac devices and 15 individuals with high power devices lacked access to care. The model developed estimates a growth rate of 7 to 10% annually. The pacemaker clinic will provide access to over 70 individuals lacking care for their pacemakers, thereby resulting in improved healthcare outcomes, fewer preventable complications, and optimal device performance.

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Nursing Commons