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A nurse practitioner intervention model to maximize efficient use of telemetry resources.
Peter A Gross1, Denise Patriaco, Kellie McGuire
1Department of Internal Medicine, Hackensack University Medical Center (HUMC), Hackensack, New Jersey, USA. pgross237@aol.com
The Joint Commission Journal on Quality Improvement
|October 9, 2002
Summary
An advanced practice nurse (APN) model reduced unnecessary telemetry monitoring by 34%, improving efficiency and patient care. This intervention increased the number of eligible patients receiving telemetry.
Area of Science:
- Cardiovascular Medicine
- Nursing Practice
- Healthcare Management
Background:
- Telemetry monitoring is crucial for detecting dysrhythmias but is often overused in hospitals.
- Inefficient use of telemetry impacts resource availability and patient care.
- Previous guidelines (1998) did not resolve overuse issues at Hackensack University Medical Center.
Purpose of the Study:
- To evaluate the effectiveness of an advanced practice nurse (APN) model in reducing the overuse of telemetry monitoring.
- To improve the efficiency of telemetry bed allocation and utilization.
Main Methods:
- An APN provided concurrent review and intervention for floating telemetry patients.
- The APN intervened with physicians for patients on telemetry longer than 48 hours without meeting guidelines.
- Data collected for 11 months pre-intervention and 29 months post-intervention.
Main Results:
- Mean telemetry hours per patient decreased by 34% (from 65.2 to 49.6 hours).
- This reduction was statistically significant (p < 0.0001).
- The intervention led to an increased number of patients per month utilizing telemetry.
Conclusions:
- The APN model demonstrated immediate and significant improvements in telemetry utilization.
- This proactive approach is effective for quality improvement initiatives in healthcare settings.