2.50
Hdl Handle:
http://hdl.handle.net/10755/162968
Type:
Presentation
Title:
The Use of ST-segment Monitoring by Nurses in the Emergency Department
Abstract:
The Use of ST-segment Monitoring by Nurses in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Hart, Leigh, RN, CCRN, PhD
P.I. Institution Name:Jacksonville University
Contact Address:2800 University Boulevard North, Jacksonville, FL, 32211, USA
Contact Telephone:(904) 256-7281
Purpose: Chest pain is a common complaint in the emergency department (ED). Deciding which patients to admit to the hospital and which patients to discharge presents a challenge, especially given the high cost of hospitalization. A consensus statement released by the ST-Segment Monitoring Practice Guideline International Working Group recommends continuous ST-segment monitoring in the emergency department as a less-costly alternative to hospital admission for patients with symptoms suggestive of ischemia who do not show electrocardiogram (ECG) or enzyme evidence of ischemia. Although ST-segment monitoring is recommended for use in the emergency department, little is known about its actual use. The purpose of this study was to explore the use of ST-segment monitoring technology by ED nurses in the United States. In addition, this study sought to identify the characteristics of emergency departments that are associated with its use. Design: This study was a replication of a descriptive study that used a survey to explore the use of ST-segment monitoring among nurses in the intensive care unit. Setting: Surveys were mailed to ED nurses in emergency departments throughout the United States. The emergency departments varied by ED level and hospital size. Sample: A sample of 500 ED nurses were randomly selected from a complete list of Emergency Nurses Association members. Institutional review board approval was obtained prior to conducting the study. Methodology: Permission was obtained from the authors of the original study to use their instrument, and slight modifications were made to reflect differences in the ED environment. The modified survey contained closed-ended questions about hospital and ED size, cardiac procedures conducted at the facility, brand of monitors in the emergency department, and whether or not ST-segment monitoring was used. Those who reported ST-segment monitoring use were asked to complete questions about lead selection and additional Likert scale items concerning perceptions of the usefulness and value of this technology. Those who did not report its use were asked to discuss reasons for the lack of use in a short-answer section. Respondents were asked not to provide their names on the survey. Results: One hundred surveys (20% response rate) representing all levels of emergency departments from a broad geographical region of the United States were returned. Thirty-three percent of respondents indicated use of ST-segment monitoring in their emergency department. Chi-square, and t-test analyses indicated no relationship between use of ST-segment monitoring and ED level, hospital size, monitor brand, hospital location, or mean ED bed number. Respondents who reported that their emergency department did not use ST-segment monitoring cited reasons, including omission from standards of care, lack of education, and inadequate monitoring systems. Written comments indicated that respondents utilized ST-segment monitoring more often as a means to monitor cases of known cardiac ischemia, and less often as a method to evaluate questionable or intermittent cardiac ischemia. Conclusions: This research indicates that there is a need for additional nursing education regarding the use of ST-segment monitoring. ED clinicians should discuss the potential benefit of using this technology to serve their patient population. If ST-segment monitoring is determined to be a potential benefit, standards of care and equipment should be evaluated and updated as indicated.
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.titleThe Use of ST-segment Monitoring by Nurses in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162968-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Use of ST-segment Monitoring by Nurses in the Emergency Department</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">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hart, Leigh, RN, CCRN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Jacksonville University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2800 University Boulevard North, Jacksonville, FL, 32211, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(904) 256-7281</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lhart@ju.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Chest pain is a common complaint in the emergency department (ED). Deciding which patients to admit to the hospital and which patients to discharge presents a challenge, especially given the high cost of hospitalization. A consensus statement released by the ST-Segment Monitoring Practice Guideline International Working Group recommends continuous ST-segment monitoring in the emergency department as a less-costly alternative to hospital admission for patients with symptoms suggestive of ischemia who do not show electrocardiogram (ECG) or enzyme evidence of ischemia. Although ST-segment monitoring is recommended for use in the emergency department, little is known about its actual use. The purpose of this study was to explore the use of ST-segment monitoring technology by ED nurses in the United States. In addition, this study sought to identify the characteristics of emergency departments that are associated with its use. Design: This study was a replication of a descriptive study that used a survey to explore the use of ST-segment monitoring among nurses in the intensive care unit. Setting: Surveys were mailed to ED nurses in emergency departments throughout the United States. The emergency departments varied by ED level and hospital size. Sample: A sample of 500 ED nurses were randomly selected from a complete list of Emergency Nurses Association members. Institutional review board approval was obtained prior to conducting the study. Methodology: Permission was obtained from the authors of the original study to use their instrument, and slight modifications were made to reflect differences in the ED environment. The modified survey contained closed-ended questions about hospital and ED size, cardiac procedures conducted at the facility, brand of monitors in the emergency department, and whether or not ST-segment monitoring was used. Those who reported ST-segment monitoring use were asked to complete questions about lead selection and additional Likert scale items concerning perceptions of the usefulness and value of this technology. Those who did not report its use were asked to discuss reasons for the lack of use in a short-answer section. Respondents were asked not to provide their names on the survey. Results: One hundred surveys (20% response rate) representing all levels of emergency departments from a broad geographical region of the United States were returned. Thirty-three percent of respondents indicated use of ST-segment monitoring in their emergency department. Chi-square, and t-test analyses indicated no relationship between use of ST-segment monitoring and ED level, hospital size, monitor brand, hospital location, or mean ED bed number. Respondents who reported that their emergency department did not use ST-segment monitoring cited reasons, including omission from standards of care, lack of education, and inadequate monitoring systems. Written comments indicated that respondents utilized ST-segment monitoring more often as a means to monitor cases of known cardiac ischemia, and less often as a method to evaluate questionable or intermittent cardiac ischemia. Conclusions: This research indicates that there is a need for additional nursing education regarding the use of ST-segment monitoring. ED clinicians should discuss the potential benefit of using this technology to serve their patient population. If ST-segment monitoring is determined to be a potential benefit, standards of care and equipment should be evaluated and updated as indicated.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:16Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:16Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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