ST-Map ECG Software Improves Nurses' Use of and Attitude toward Ischemia Monitoring and the Quality of Patient Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/157103
Category:
Abstract
Type:
Presentation
Title:
ST-Map ECG Software Improves Nurses' Use of and Attitude toward Ischemia Monitoring and the Quality of Patient Care
Author(s):
Funk, Marjorie; Sangkachand, Prasama; Phung, Jennifer; Gaither, Julie; Mercurio, Angela; Jahrsdoerfer, Mary; Gorero, Noreen; Sarosario, Brenda; Lorusso, Francine
Author Details:
Marjorie Funk, Yale University School of Nursing, New Haven, Connecticut, USA, email: marjorie.funk@yale.edu; Prasama Sangkachand; Jennifer Phung; Julie Gaither; Angela Mercurio; Mary Jahrsdoerfer; Noreen Gorero; Brenda Sarosario; Francine Lorusso
Abstract:
PURPOSE: Evidence suggests that nurses do not activate the ST segment monitoring feature on the bedside monitor because they perceive it to be difficult to use. ST-Map ECG software was designed to make ST segment ischemia monitoring easier by incorporating graphical displays of ongoing ischemia. The purpose of this study was to determine if nurses' use of and attitude toward ischemia monitoring and the quality of patient care related to ECG monitoring improve with the availability of ST-Map software. BACKGROUND: Studies show that although 80 to 90% of transient ischemic events are asymptomatic, they are significant markers for adverse outcomes. Nurses should activate continuous ST segment monitoring to identify patients with acute, but often silent myocardial ischemia. The American Heart Association / AACN Practice Standards for ECG Monitoring recommend ST segment monitoring for all patients at significant risk for myocardial ischemia that, if sustained, may result in acute MI or extension of an MI. METHODS: This one-group pre-/post-intervention study of 61 staff nurses and 202 patients with acute coronary syndrome was conducted in the Cardiac ICU at Yale-New Haven Hospital. We obtained baseline data on nurses' use of and attitude toward ischemia monitoring and the quality of patient care. We then provided education on ischemia monitoring and the ST-Map software, and the ST-Map software was installed on all bedside monitors. Nurses used the new ST-Map software for 4 months. We then obtained follow-up data on the same outcomes we examined at baseline. We used the McNemar test (nurse data) and chi square and t-test (patient data) to determine changes with the availability of ST-Map software. RESULTS: The sample of 61 nurses was 93% female, with a mean age of 41 years. Before ST-Map was instituted 13% of the nurses had ever used ST segment monitoring vs. 90% after ST-Map (p<.001). The most common reason for not using ST segment monitoring before ST-Map was inadequate knowledge (62%). The most common reason for liking ST segment monitoring after ST-Map was knowing when patient has ischemia (80%). The sample of 202 patients was 73% male, with a mean age of 62 years. Time to acquisition of a 12-lead ECG in response to symptoms or ST segment changes before ST-Map was 5-15 minutes vs. always <5 minutes after ST-Map (p<.001). There was no difference in time to return to cardiac cath lab. CONCLUSIONS: The new ST-Map ischemia monitoring software was associated with more frequent use of ST segment monitoring and improved attitudes of nurses toward it. It was also associated with a shorter time to the acquisition of a 12-lead ECG in response to symptoms or ST segment changes. Additional research with larger samples is needed to examine the association of ST-Map with patient outcomes. Evaluation of ST-Map in other patient care settings and with broader patient populations is also indicated.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleST-Map ECG Software Improves Nurses' Use of and Attitude toward Ischemia Monitoring and the Quality of Patient Careen_GB
dc.contributor.authorFunk, Marjorieen_GB
dc.contributor.authorSangkachand, Prasamaen_GB
dc.contributor.authorPhung, Jenniferen_GB
dc.contributor.authorGaither, Julieen_GB
dc.contributor.authorMercurio, Angelaen_GB
dc.contributor.authorJahrsdoerfer, Maryen_GB
dc.contributor.authorGorero, Noreenen_GB
dc.contributor.authorSarosario, Brendaen_GB
dc.contributor.authorLorusso, Francineen_GB
dc.author.detailsMarjorie Funk, Yale University School of Nursing, New Haven, Connecticut, USA, email: marjorie.funk@yale.edu; Prasama Sangkachand; Jennifer Phung; Julie Gaither; Angela Mercurio; Mary Jahrsdoerfer; Noreen Gorero; Brenda Sarosario; Francine Lorussoen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157103-
dc.description.abstractPURPOSE: Evidence suggests that nurses do not activate the ST segment monitoring feature on the bedside monitor because they perceive it to be difficult to use. ST-Map ECG software was designed to make ST segment ischemia monitoring easier by incorporating graphical displays of ongoing ischemia. The purpose of this study was to determine if nurses' use of and attitude toward ischemia monitoring and the quality of patient care related to ECG monitoring improve with the availability of ST-Map software. BACKGROUND: Studies show that although 80 to 90% of transient ischemic events are asymptomatic, they are significant markers for adverse outcomes. Nurses should activate continuous ST segment monitoring to identify patients with acute, but often silent myocardial ischemia. The American Heart Association / AACN Practice Standards for ECG Monitoring recommend ST segment monitoring for all patients at significant risk for myocardial ischemia that, if sustained, may result in acute MI or extension of an MI. METHODS: This one-group pre-/post-intervention study of 61 staff nurses and 202 patients with acute coronary syndrome was conducted in the Cardiac ICU at Yale-New Haven Hospital. We obtained baseline data on nurses' use of and attitude toward ischemia monitoring and the quality of patient care. We then provided education on ischemia monitoring and the ST-Map software, and the ST-Map software was installed on all bedside monitors. Nurses used the new ST-Map software for 4 months. We then obtained follow-up data on the same outcomes we examined at baseline. We used the McNemar test (nurse data) and chi square and t-test (patient data) to determine changes with the availability of ST-Map software. RESULTS: The sample of 61 nurses was 93% female, with a mean age of 41 years. Before ST-Map was instituted 13% of the nurses had ever used ST segment monitoring vs. 90% after ST-Map (p<.001). The most common reason for not using ST segment monitoring before ST-Map was inadequate knowledge (62%). The most common reason for liking ST segment monitoring after ST-Map was knowing when patient has ischemia (80%). The sample of 202 patients was 73% male, with a mean age of 62 years. Time to acquisition of a 12-lead ECG in response to symptoms or ST segment changes before ST-Map was 5-15 minutes vs. always <5 minutes after ST-Map (p<.001). There was no difference in time to return to cardiac cath lab. CONCLUSIONS: The new ST-Map ischemia monitoring software was associated with more frequent use of ST segment monitoring and improved attitudes of nurses toward it. It was also associated with a shorter time to the acquisition of a 12-lead ECG in response to symptoms or ST segment changes. Additional research with larger samples is needed to examine the association of ST-Map with patient outcomes. Evaluation of ST-Map in other patient care settings and with broader patient populations is also indicated.en_GB
dc.date.available2011-10-26T19:25:25Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:25:25Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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