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Appropriate utilisation of cardiac telemetry monitoring: a quality improvement project
  1. Ky B Stoltzfus1,
  2. Maharshi Bhakta2,
  3. Caylin Shankweiler2,
  4. Rebecca R Mount2,
  5. Cheryl Gibson2
  1. 1Department of Internal Medicine and Palliative Medicine, The University of Kansas Health System, Kansas City, Kansas, USA
  2. 2Department of Internal Medicine, The University of Kansas Health System, Kansas City, Kansas, USA
  1. Correspondence to Dr Ky B Stoltzfus; kstoltzfus{at}kumc.edu

Abstract

For hospitals located in the United States, appropriate use of cardiac telemetry monitoring can be achieved resulting in cost savings to healthcare systems. Our institution has a limited number of telemetry beds, increasing the need for appropriate use of telemetry monitoring to minimise delays in patient care, reduce alarm fatigue, and decrease interruptions in patient care.

This quality improvement project was conducted in a single academic medical centre in Kansas City, Kansas. The aim of the project was to reduce inappropriate cardiac telemetry monitoring on intermediate care units. Using the 2004 American Heart Association guidelines to guide appropriate telemetry utilisation, this project team sought to investigate the effects of two distinct interventions to reduce inappropriate telemetry monitoring, huddle intervention and mandatory order entry. Telemetry utilisation was followed prospectively for 2 years.

During our initial intervention, we achieved a sharp decline in the number of patients on telemetry monitoring. However, over time the efficacy of the huddle intervention subsided, resulting in a need for a more sustained approach. By requiring physicians to input indication for telemetry monitoring, the second intervention increased adherence to practice guidelines and sustained reductions in inappropriate telemetry use.

  • continuous quality improvement
  • hospital medicine
  • PDSA
  • heart

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors KS designed the study as principal investigator and executed the interventions. He also contributed to the collection and analysis of data, and drafted and revised the manuscript. MB contributed to the overall study design and implementation. He also collected and analysed data, and participated in drafting and revising the manuscript. CS and RM analysed data, developed the figures and tables, and assisted with drafting and revising the manuscript. CG advised on the data collection process, facilitated data analysis and participated in drafting and revising the manuscript. All authors have reviewed and approve of the final manuscript.

  • Funding This QI project was unfunded.

  • Competing interests None declared.

  • Patient consent for publication This project was approved by the local institutional review board and designated as quality improvement.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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