RT Journal Article
SR Electronic
T1 Appropriate utilisation of cardiac telemetry monitoring: a quality improvement project
JF BMJ Open Quality
JO BMJ Open Qual
FD British Medical Journal Publishing Group
SP e000560
DO 10.1136/bmjoq-2018-000560
VO 8
IS 2
A1 Ky B Stoltzfus
A1 Maharshi Bhakta
A1 Caylin Shankweiler
A1 Rebecca R Mount
A1 Cheryl Gibson
YR 2019
UL http://bmjopenquality.bmj.com/content/8/2/e000560.abstract
AB 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.