Patient and Nurse-Related Implications of Remote Cardiac Telemetry

Abstract

The purposes of this study were (a) to determine the frequency of rhythm disturbance events among patients on remote cardiac telemetry, (b) to identify how many of these events were detected by the telemetry nurses, and (c) to explore the impact of managing telemetry on nurses' workload. This prospective observational study took place in a nine-bed Coronary Respiratory Care Unit (CRCU) in a tertiary Canadian University Hospital. No lethal arrhythmias were detected during 420 hours of observation. There were a high number of remote telemetry warning arrhythmias, the vast majority of which were artifact (80.2%). A warning alarm occurred every 2.1 to 6.2 minutes. Nurses detected between 60% to 100% of valid warning alarms. Remote cardiac telemetry without a dedicated monitor-watcher places unnecessary demand on CRCU nurses' time because the vast majority of arrhythmia alarms are inconsequential. The addition of monitoring remote telemetry to the CRCU nurse's workload has the potential to negatively influence the care provided to CRCU patients.

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References

Benner, P. (1984). From novice to expert. Excellence in power in clinical nursing practice. Menio Park, CA: Addison-Wesley.

Benner, P., Tanner C., & Chelsa, C. (1992). From beginner to expert: Gaining a differentiated clinical world in critical care nursing. Advanced Nursing Science, 14(3), 13-28.

Estrada, C. A., Rosman, H. S., Prasad, N. K., Battilana G., Alexander, M., Held, A. C., et al. (2000). Evaluation of guideline for the use of telemetry in the non-intensive care setting. Journal of Internal Medicine, 15(1), 51-55.

Estrada, C. A., Rosman, H. S., Prasad, N. K., Battilana, G., Alexander, M., Held, A. C., et al. (1995). The role of telemetry monitoring in the non-intensive care unit. American Journal of Cardiology, 76, 960-965.

Estrada, C. A., Prasad, N. K., Rosman, H. S., & Young, M. J. (1994). Outcomes of patients hospitalized to a telemetry unit. American Journal of Cardiology, 74, 357-361.

Kelsey, J. L., Whittlemore, A. S., Evans, A. S., Thompson, W. D. (1996). Prospective cohort studies: Planning and execution. In Methods in observational epidemiology (2nd ed.). New York: Oxford University Press 86-112.

Stukshis, I., Funk, M., Johnson, C., & Parjosewich, J. (1997). Accuracy of detection of clinically important dysrhythmias with and without a dedicated monitor watcher. American Journal of Critical Care, 6(4), 312-317.