Nurses’ Practices and Lead Selection in Monitoring for Myocardial Ischemia

Blakeman, John R.; Sarsfield, Katherine; Booker, Kathy J.

doi:10.1097/dcc.0000000000000118

Cited by 12 publications

(20 citation statements)

References 2 publications

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“…In this study, nurses interviewed mentioned that having additional training every two years was insufficient to maintain their sense of proficiency in ECG interpretation due to lack of exposure, with one participant saying, ‘once I left the classroom, I never saw it again’ (Nickasch, 2016, p. 421). Seven quantitative studies identified improvement in nurses’ confidence, comfort or perception in ECG interpretation (Blakeman et al, 2015; Brooks et al, 2016; Sangkachand et al, 2011; Spiva et al, 2012; Tai et al, 2012; Throndson & Davis, 2015; Wilson et al, 2012), along with an increase in mean ECG knowledge scores after educational interventions. Only one study demonstrated no correlation between previous ECG education and ambulance nurses’ ECG interpretation skills (Werner et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

“…Five assessment tools focused on knowledge and perceptions of or confidence in ECG interpretation (Fålun et al, 2020; Koning et al, 2019; Spiva et al, 2012; Throndson & Davis, 2015; Wilson et al, 2012). Three tools explored ECG knowledge and practice patterns (Blakeman et al, 2015; Thomason et al, 1995; Zhou et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies reported nurses’ attitudes around continuous monitoring (Blakeman et al, 2015; Nickasch, 2016; Sangkachand et al, 2011; Zhou et al, 2012). Attitudes around continuous monitoring changed positively due to an educational intervention in one study (Blakeman et al, 2015) and ST mapping in another study (Sangkachand et al, 2011). Nurses in medical‐surgical and cardiac step‐down units who were interviewed in a qualitative study about ECG rhythm analysis expressed insecurity when caring for monitored patients.…”

Section: Resultsmentioning

confidence: 99%

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

Chen

Kunst

Nasrawi

et al. 2022

Journal of Advanced Nursing

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

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

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“…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

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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.

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“…A good understanding of how to review alarm data and trends can also help RNs realize which alarms require immediate attention [31]. Suggestions to improve RNs' knowledge include online education [32]. This is similar to the suggestion by the American Association of Critical Care Nurses that retraining RNs on individualizing alarm parameters may help reduce inactionable alarms [8].…”

Section: Nurse and Patient Educationmentioning

confidence: 99%

Electrocardiographic Alarms in the Acute Care Setting

Zhang¹,

Weathers²

2018

JNHC

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Electrocardiographic [ECG] alarms are used in acute care settings to continuously monitor patients' cardiac status, and to alert clinicians to potentially life-threatening changes in a patient's condition. However, the numbers of alarms in the acute care setting have increased exponentially in the past 20 years. This was to ensure patient safety, and to avoid adverse events that could end in litigations [1]. Cardiac alarms represent the second most frequent alarm in the acute care setting at 37% [2]. Although ECG alarms may help save lives, proper alarm management has been problematic and ECG alarms that were designed to enhance patient safety have become a top national safety hazard. Registered Nurses [RNs] must respond to a variety of alarms in acute care settings; however many of these alarms require no action because they may not be triggered by an actual health need. Responding to non-actionable alarms can interrupt nursing workflow, increase the likelihood of clinical errors, and can lead to alarm fatigue and nurse burnout, as well as serious financial consequences for the organizations. This paper discusses problems with ECG alarm management as experienced by RN's, and provides suggestions to improve alarm management in acute care settings. Keywords-alarm management; alarm fatigue, electrocardiographic alarms; acute care setting. the Joint Commission made effective alarm management an accreditation requirement for all hospitals [2].

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Nurses’ Practices and Lead Selection in Monitoring for Myocardial Ischemia

Cited by 12 publications

References 2 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

Electrocardiographic Alarms in the Acute Care Setting

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