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Tuesday, 14 July 2009
Learning Objective 1: 1. develop safety strategies for clinical practices, staff education and ongoing competency with EKGs.
Learning Objective 2: 2. select the most appropriate monitoring technology for their work environment.
Creating Safety Strategies for Cardiac Monitored Patients:
A Multi-system Integrated Approach
Nancy Tankel, RN, MN
Yolanda Ramirez, RN, MPH
Purpose: The purpose of this project was to take a multi-system approach to develop safety strategies for cardiac monitoring. An increased demand for telemetry beds for sicker and older patients along with evolving technology with its competing noises and different architectural design caused us to reassess the implications and practice of providing safe telemetry monitoring.
Methods: A group of physicians, nurse managers, front-line staff, and union leaders formed three teams to develop safety strategies for: 1) clinical practice, 2) technical support equipment and 3) staff education with ongoing EKG competencies.
After review of the literature and the best practices of our staff nurses, our team designed a collaborative and comprehensive program. Key elements include standards for alarm settings, daily assessment of patient’s need for monitoring, a transportation trip ticket, communication handoffs and EKG competencies and education. We also designed safe systems to support staff through technology.
IT provided education on new technology and shared how to assess one’s unit to select the best configuration for a safe telemetry system.
Results: We developed a comprehensive telemetry monitoring safety program that standardizes our delivery of care to telemetry patients across our health care system. And, all of our medical centers inSouthern California are adopting these safety strategies. Future research is needed to evaluate whether one safety practice is more effective than other, i.e., monitor technicians vs. beeper system, or on site telemetry vs. remote telemetry.
Conclusion: Based on current research of this topic and our completed committee work, we strongly recommend that health care systems move telemetry monitoring from a single diagnostic activity to a comprehensive program approach, which is multidisciplinary and collaborative, to best meet the needs of our monitored patients.
A Multi-system Integrated Approach
Nancy Tankel, RN, MN
Yolanda Ramirez, RN, MPH
Purpose: The purpose of this project was to take a multi-system approach to develop safety strategies for cardiac monitoring. An increased demand for telemetry beds for sicker and older patients along with evolving technology with its competing noises and different architectural design caused us to reassess the implications and practice of providing safe telemetry monitoring.
Methods: A group of physicians, nurse managers, front-line staff, and union leaders formed three teams to develop safety strategies for: 1) clinical practice, 2) technical support equipment and 3) staff education with ongoing EKG competencies.
After review of the literature and the best practices of our staff nurses, our team designed a collaborative and comprehensive program. Key elements include standards for alarm settings, daily assessment of patient’s need for monitoring, a transportation trip ticket, communication handoffs and EKG competencies and education. We also designed safe systems to support staff through technology.
IT provided education on new technology and shared how to assess one’s unit to select the best configuration for a safe telemetry system.
Results: We developed a comprehensive telemetry monitoring safety program that standardizes our delivery of care to telemetry patients across our health care system. And, all of our medical centers in
Conclusion: Based on current research of this topic and our completed committee work, we strongly recommend that health care systems move telemetry monitoring from a single diagnostic activity to a comprehensive program approach, which is multidisciplinary and collaborative, to best meet the needs of our monitored patients.
See more of: Accepted EBP Posters
See more of: Evidence-Based Practice Sessions – Oral Paper & Posters
See more of: Evidence-Based Practice Sessions – Oral Paper & Posters