Improving Nursesʼ Knowledge of Continuous ST-Segment Monitoring

Chronister, Connie

doi:10.1097/nci.0000000000000029

Cited by 10 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nurses' knowledge of rhythm interpretation and their ability to manage arrhythmias was evaluated in three studies (Brooks et al, 2016;Costanzo et al, 2013;Entenmann et al, 2018). One study assessed knowledge of continuous monitoring and intervening with rhythm abnormalities (Chronister, 2014). Educational interventions, including team-based learning (Kim & Kim, 2020), training in the use of atrial electrograms (McRae et al, 2010), the Cardiac Rhythm Identification for Simple People (CRISP) method (Çıkrıkçı Isık et al, 2020), and the lecture-discussion approach (VanArsdale, 1998), all led to significant improvement in nurses' knowledge of ECG interpretation.…”

Section: Knowledge Of Ecg Interpretationmentioning

confidence: 99%

“…Eight studies reported that validity and reliability of the tools was confirmed (Brooks et al, 2016;Chronister, 2014;Coll-Badell et al, 2017;Ho et al, 2021;Keller et al, 2020;Lamb & Henderson, 1993;VanArsdale, 1998;Zhang & Hsu, 2013). Two studies used previously validated tools (Rahimpour et al, 2021;Spiva et al, 2012).…”

Section: Validity and Reliability Of The Competency Toolsmentioning

confidence: 99%

See 1 more Smart Citation

Nurses’ competency in electrocardiogram interpretation in acute care settings: A systematic review

Chen

Kunst

Nasrawi

et al. 2022

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aims Identify and synthesize evidence of nurses’ competency in electrocardiogram interpretation in acute care settings. Design Systematic mixed studies review. Data sources Cumulative Index to Nursing and Allied Health Literature, Medline, Scopus and Cochrane were searched in April 2021. Review methods Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta‑Analysis framework. A data‐based convergent synthesis design using qualitative content analysis was adopted. Quality appraisal was undertaken using validated tools appropriate to study designs of the included papers. Results Forty‐three papers were included in this review. Skills and attitudes were not commonly assessed, as most studies referred to ‘competency’ in the context of nurses’ knowledge in electrocardiogram interpretation. Nurses’ knowledge levels in this important nursing role varied notably, which could be partly due to a range of assessment tools being used. Several factors were found to influence nurses’ competency in electrocardiogram interpretation across the included studies from individual, professional and organizational perspectives. Conclusion The definition of ‘competency’ was inconsistent, and nurses’ competency in electrocardiogram interpretation varied from low to high. Nurses identified a lack of regular training and insufficient exposure in electrocardiogram interpretation. Hence, regular, standard training and education are recommended. Also, more research is needed to develop a standardized and comprehensive electrocardiogram interpretation tool, thereby allowing educators to safely assess nurses’ competency. Impact This review addressed questions related to nurses’ competency in electrocardiogram interpretation. The findings highlight varying competency levels and assessment methods. Nurses reported a lack of knowledge and confidence in interpreting electrocardiograms. There is an urgent need to explore opportunities to promote and maintain nurses’ competency in electrocardiogram interpretation.

show abstract

Section: Knowledge Of Ecg Interpretationmentioning

confidence: 99%

Section: Validity and Reliability Of The Competency Toolsmentioning

confidence: 99%

Nurses’ competency in electrocardiogram interpretation in acute care settings: A systematic review

Chen

Kunst

Nasrawi

et al. 2022

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…In the PULSE trial, accuracy of documented arrhythmia interpretation by nurses improved from 82% correct to 97% after an interactive online electrocardiographic monitoring education program in the experimental group. 6 Both nurses 465,466 and physicians 467,468 report a significant increase in knowledge with an educational intervention for electrocardiographic monitoring.…”

Section: Education Of Staffmentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

198

214

View full text Add to dashboard Cite

Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

show abstract

“…47 Additionally, several quality assurance projects have shown that educational programs improve nurses knowledge and use of ST-segment monitoring. 48–50 This technology has the potential to identify high risk patients requiring treatment adjustments. Finally, while we highlight the usefulness of ECG monitoring for detection of TMI, this software might also be useful for ruling out cardiac pathology in patients with symptoms suggestive of ACS, in which there is not a cardiac cause.…”

Section: Discussionmentioning

confidence: 99%

Among Unstable Angina and Non–ST-Elevation Myocardial Infarction Patients, Transient Myocardial Ischemia and Early Invasive Treatment Are Predictors of Major In-hospital Complications

et al. 2016

View full text Add to dashboard Cite

Background Treatment for unstable angina (UA) or non-STEMI (NSTEMI) is aimed at plaque stabilization to prevent infarction. Two treatment strategies are: (1) invasive (i.e., cardiac catheterization laboratory < 24 hours after admission), or (2) selectively invasive (i.e., medications with cardiac catheterization laboratory > 24 hours for recurrent symptoms). However, it is not known if the frequency of transient myocardial ischemia (TMI), or complications during hospitalization varies by treatment. Purpose We examine; (1) occurrence of TMI in UA/NSTEMI, (2) compare frequency of TMI by treatment pathway and (3) determine predictors of in-hospital complications (i.e., death, MI, pulmonary edema, shock, arrhythmia w/intervention). Method Hospitalized patients with CAD (i.e., history of MI, PCI/stent, CABG, > 50% lesion via angiogram, or positive troponin) were recruited and 12-lead ECG Holter initiated. Clinicians, blinded to Holter data, decided treatment strategy; off-line analysis was done post discharge. TMI was defined as > 1 mm ST-segment ↑ or ↓, in > 1 ECG lead, > 1 minute. Results Of 291 patients, 91% were white, 66% male, 44% prior MI, and 59% prior PCI/stent or CABG. Treatment pathway was early in 123 (42%), and selective in 168 (58%). Forty-nine (17%) had TMI; 19 (15%) early invasive, 30 (18%) selective (p = 0.637). Acute MI after admission was higher in patients with TMI regardless of treatment strategy (early no TMI 4% vs yes TMI 21%; p = 0.020; selective no TMI 1% vs yes TMI 13%; p = .0004). Predictors of major in-hospital complication were TMI (OR 9.9; 95% CI, 3.84 to 25.78), and early invasive (OR 3.5; 95% CI, 1.23 to 10.20). Conclusions In UA/NSTEMI patients treated with contemporary therapies, TMI in not uncommon. The presence of TMI and early invasive treatment are predictors of major in-hospital complications.

show abstract

Improving Nursesʼ Knowledge of Continuous ST-Segment Monitoring

Cited by 10 publications

References 14 publications

Nurses’ competency in electrocardiogram interpretation in acute care settings: A systematic review

Nurses’ competency in electrocardiogram interpretation in acute care settings: A systematic review

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Among Unstable Angina and Non–ST-Elevation Myocardial Infarction Patients, Transient Myocardial Ischemia and Early Invasive Treatment Are Predictors of Major In-hospital Complications

Contact Info

Product

Resources

About