2.50
Hdl Handle:
http://hdl.handle.net/10755/162849
Type:
Presentation
Title:
Improving Ischemia Detection with ST-Segment Monitoring in the ED
Abstract:
Improving Ischemia Detection with ST-Segment Monitoring in the ED
Conference Sponsor:Emergency Nurses Association
Conference Year:2003
Author:Hackenschmidt, Angela, RN, BSN, CEN
P.I. Institution Name:University of California, San Francisco
Title:Angela Hackenschmidt, RN, BSN, CEN
Contact Address:226 Shrader St., San Francisco, CA, 94117, USA
Contact Telephone:(415) 353-1238
Co-Authors:Jinhee Nguyen, RN, MSN, CEN and Barbara Drew, RN, PhD, FAAN
Purpose: Continuous ST-segment monitoring has been shown to be more sensitive than a single 12-lead electrocardiogram in detecting acute ischemia in patients who present to the emergency department (ED) with possible myocardial infarction. Although experts recommend ST monitoring, and such capability exists in current bedside monitors, it is currently underutilized. Therefore, the purpose of this project was to improve ischemia detection via implementation of ST monitoring in the emergency department. Design: This research utilization project combined technology upgrades and various educational strategies to improve cardiac monitoring nursing practice in the emergency department. Setting and Participants: Eleven monitored beds in a 28-bed, urban, tertiary-care university hospital emergency department were made capable of ST-segment monitoring via five-lead cable electrodes. Key participants included a nurse researcher, clinical nurse specialist, unit educator, and all nursing staff in the emergency department. Methods: The project consisted of five phases: (1) ensuring competency of nurses with basic cardiac monitoring skills; (2) upgrading from 3-lead to the required 5-lead patient monitoring cables; (3) educating nurses in the use of and rationale for ST-monitoring; (4) implementing routine use of ST-monitoring in the ED; and (5) collecting case studies to demonstrate outcomes of patients receiving ST monitoring. Patient cable and monitor software upgrades were provided by Philips Medical (Andover, MA). Results: ACLS-certified ED nurses (n=45) were taught about the ST-segment monitoring using poster board in-services, a staff meeting presentation, a one-page self-learning module, and demonstration at a competency day. The nurses demonstrated competency with basic skills, including accurate lead placement, and an audit tool was developed to assess continued compliance. Reference guides were created and placed with bedside monitors, and nurses are implementing ST monitoring. Case studies are being collected. Recommendations: Implementation of ischemia monitoring in the ED setting is feasible with advance planning, multiple innovative educational strategies, continuous clinical support for nurses, and ongoing evaluation of the value of ST monitoring to patients. [Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving Ischemia Detection with ST-Segment Monitoring in the EDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162849-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving Ischemia Detection with ST-Segment Monitoring in the ED</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hackenschmidt, Angela, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California, San Francisco</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Angela Hackenschmidt, RN, BSN, CEN</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">226 Shrader St., San Francisco, CA, 94117, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(415) 353-1238</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Angela.Hackenschmidt@ucsfmedctr.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jinhee Nguyen, RN, MSN, CEN and Barbara Drew, RN, PhD, FAAN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Continuous ST-segment monitoring has been shown to be more sensitive than a single 12-lead electrocardiogram in detecting acute ischemia in patients who present to the emergency department (ED) with possible myocardial infarction. Although experts recommend ST monitoring, and such capability exists in current bedside monitors, it is currently underutilized. Therefore, the purpose of this project was to improve ischemia detection via implementation of ST monitoring in the emergency department. Design: This research utilization project combined technology upgrades and various educational strategies to improve cardiac monitoring nursing practice in the emergency department. Setting and Participants: Eleven monitored beds in a 28-bed, urban, tertiary-care university hospital emergency department were made capable of ST-segment monitoring via five-lead cable electrodes. Key participants included a nurse researcher, clinical nurse specialist, unit educator, and all nursing staff in the emergency department. Methods: The project consisted of five phases: (1) ensuring competency of nurses with basic cardiac monitoring skills; (2) upgrading from 3-lead to the required 5-lead patient monitoring cables; (3) educating nurses in the use of and rationale for ST-monitoring; (4) implementing routine use of ST-monitoring in the ED; and (5) collecting case studies to demonstrate outcomes of patients receiving ST monitoring. Patient cable and monitor software upgrades were provided by Philips Medical (Andover, MA). Results: ACLS-certified ED nurses (n=45) were taught about the ST-segment monitoring using poster board in-services, a staff meeting presentation, a one-page self-learning module, and demonstration at a competency day. The nurses demonstrated competency with basic skills, including accurate lead placement, and an audit tool was developed to assess continued compliance. Reference guides were created and placed with bedside monitors, and nurses are implementing ST monitoring. Case studies are being collected. Recommendations: Implementation of ischemia monitoring in the ED setting is feasible with advance planning, multiple innovative educational strategies, continuous clinical support for nurses, and ongoing evaluation of the value of ST monitoring to patients. [Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:35:12Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:35:12Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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