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Patient Directed Recording of a Bipolar Three-Lead Electrocardiogram using a Smartwatch with ECG Function
Published on: December 11, 2019
Monitor-Watcher Use, Nurses' Knowledge of Electrocardiographic Monitoring, and Arrhythmia Detection.
Marjorie Funk1, Kristopher P Fennie2, Krista A Knudson3
1Marjorie Funk is the Helen Porter Jayne and Martha Prosser Jayne Professor Emerita of Nursing, Yale School of Nursing, West Haven, Connecticut.
Dedicated monitor watchers in hospitals do not improve nurses' knowledge of electrocardiographic (ECG) monitoring or arrhythmia detection accuracy. Implementing monitor-watcher programs requires careful consideration of communication protocols.
Area of Science:
- Healthcare technology assessment
- Clinical nursing practice
Background:
- Electrocardiographic (ECG) telemetry is standard in hospitals.
- Monitor watchers observe telemetry and respond to alarms.
- The impact of monitor watchers on patient care is unclear.
Purpose of the Study:
- To assess if monitor watchers enhance nurses' ECG knowledge.
- To determine if monitor watchers improve arrhythmia detection accuracy.
Main Methods:
- Analysis of data from 37 cardiac care units across 17 hospitals.
- Nurses' ECG knowledge assessed via a 20-item online test (n=1136).
- Arrhythmia detection accuracy compared monitor data to nurse documentation (n=1189 patients).
Main Results:
- 13 of 37 units (35%) utilized monitor watchers.
- Monitor watcher use showed no significant association with nurses' ECG knowledge (P = .08).
- Monitor watcher presence did not significantly correlate with improved arrhythmia detection accuracy (P = .94).
Conclusions:
- Monitor watchers did not negatively impact nurses' ECG knowledge.
- Monitor watchers did not lead to more accurate arrhythmia detection.
- Implementing monitor-watcher programs necessitates attention to critical safety elements like closed-loop communication.
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