Background: The hospital’s current policy does not reflect current American Heart Association (AHA) guidelines. Patients admitted to telemetry often stay on telemetry until discharge even though they may be downgraded earlier. There is no process to monitor the patient’s continued need for telemetry regularly. This has led to increased costs and problems with patient flow. With the influx of patients during the influenza season, this problem became a priority for the organization. There was a need for a process improvement and clearer policy guidelines to govern telemetry use.
Methods: Patients who have been on telemetry for more than 48 hours were monitored daily through a paper tool. Nurses initiated a conversation with physicians regarding the need to continue or discontinue telemetry. Data was collected for a period of 4 weeks before and 4 weeks after the intervention. The IOWA Model for Evidence-Based Practice was used to guide the project. Nurses were educated on current AHA guidelines and a post-education quiz was administered with a 100% pass rate.
Results: The pre-intervention group (n=118) had 14 downgrades compared to the post- intervention group (n=111), which had 20 downgrades. Pre-intervention data was influenced by a similar study in another telemetry unit with the same physicians. There was a 59.62% increase in savings and a 900 hour projected reduction in nursing time annually through nurse-physician collaboration. Anecdotally, staff reported an increase in downgrades in comparison to the previous year.
Conclusions: The results of this pilot study suggest that a multidisciplinary, evidence-based approach to reduce telemetry overuse can be beneficial. Further interventions can focus on the revision of policy to match current American Heart Association guidelines and closer monitoring of progress over a longer period of time.
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