Nurse Transport of Emergency Department Telemetry Patients; Is it Best Practice?

21.00
Hdl Handle:
http://hdl.handle.net/10755/198350
Category:
Abstract
Type:
Presentation
Title:
Nurse Transport of Emergency Department Telemetry Patients; Is it Best Practice?
Author(s):
Wall, Shaunlee
Author Details:
Shaunlee Wall, BSN, RN, CEN, CPEN; email: sw10@pvhs.org; shaunleew@yahoo.com
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation]Nurse Transport of Emergency Department Telemetry Patients; is it Best Practice?

Purpose: In most institutions, the clinical practice and standard of care mandates that all patients with telemetry orders must be accompanied by an RN with a monitor/defibrillator during transport. This practice continues despite mounting evidence that telemetry monitoring is of limited use in low risk patient populations. This aim of this evidenced based practice was to identify the necessity of RN’s transporting telemetry patients.

Design: A literature search was conducted using MEDLINE, CINHAL, Google Scholar, and Pub Med using key search terms ED overcrowding, telemetry monitoring and indications for cardiac monitoring.

Participants/Subjects: This was an evidenced based project initiated by ED Practice Council. Prior to initiating the project, all stakeholders including ED physicians, Hospitalists, Cardiologist, Telemetry units and the Rapid Response Team/ Code Blue Team Director were consulted. This was a literature based project with no human subjects.

Setting: The hospital is a community based, Level II Trauma Center with an extensive cardiac commitment.

Methods: Prior to initiating this project, the Practice Council consulted with the Cardiac Clinical Nurse Specialist to identify and review the history of any cases of adverse events during transport of patients with telemetry monitoring. Adverse events were defined as any event requiring the emergency treatment of a life threatening arrhythmia which would activate the hospital Code Blue team or Rapid Response Team. Since the opening of the facility in 2006, there had been no reported adverse events during transport from the Emergency Department. An extensive literature search was done to validate the use of RN’s during transport of all patients admitted with telemetry orders.

Results: The literature review supported that the transport of low risk chest pain patients, (as defined by the AHA Scientific Statement), by non-clinical staff is a safe practice. Based on the evidence, a new policy for the transport of all telemetry patients was drafted and initiated in August, 2010. Patients meeting the following criteria may be transported by an ED tech with a remote telemetry box: patients admitted to a medical bed with remote telemetry; patients with permanent, rate controlled atrial fibrillation; stable patients with chronic PVC’s; terminally ill patients who are not candidates for arrhythmia therapy; and patients who are admitted for respiratory ailments such as asthma or pneumonia without underlying cardiac disease.

Implications: It is estimated that it takes approximately 20 minutes per admission for an RN to transport telemetry patients, often leaving sicker patients in the ED without a nurse. The change in practice has improved patient flow, reduced waiting times in the ED and improved staff satisfaction.










Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011
Conference Date:
2011
Conference Name:
ENA Annual Conference 2011
Conference Host:
Emergency Nurses Association
Note:
Item supplied by the event sponsor in abstract-only format. Please contact the author(s) (if contact information is listed) and/or the event sponsor to obtain a full-text copy of this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_Us
dc.typePresentationen_US
dc.titleNurse Transport of Emergency Department Telemetry Patients; Is it Best Practice?en_GB
dc.contributor.authorWall, Shaunleeen
dc.author.detailsShaunlee Wall, BSN, RN, CEN, CPEN; email: sw10@pvhs.org; shaunleew@yahoo.comen_US
dc.identifier.urihttp://hdl.handle.net/10755/198350-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation]Nurse Transport of Emergency Department Telemetry Patients; is it Best Practice?<br/><br/>Purpose: In most institutions, the clinical practice and standard of care mandates that all patients with telemetry orders must be accompanied by an RN with a monitor/defibrillator during transport. This practice continues despite mounting evidence that telemetry monitoring is of limited use in low risk patient populations. This aim of this evidenced based practice was to identify the necessity of RN’s transporting telemetry patients.<br/><br/>Design: A literature search was conducted using MEDLINE, CINHAL, Google Scholar, and Pub Med using key search terms ED overcrowding, telemetry monitoring and indications for cardiac monitoring.<br/><br/>Participants/Subjects: This was an evidenced based project initiated by ED Practice Council. Prior to initiating the project, all stakeholders including ED physicians, Hospitalists, Cardiologist, Telemetry units and the Rapid Response Team/ Code Blue Team Director were consulted. This was a literature based project with no human subjects.<br/><br/>Setting: The hospital is a community based, Level II Trauma Center with an extensive cardiac commitment.<br/><br/>Methods: Prior to initiating this project, the Practice Council consulted with the Cardiac Clinical Nurse Specialist to identify and review the history of any cases of adverse events during transport of patients with telemetry monitoring. Adverse events were defined as any event requiring the emergency treatment of a life threatening arrhythmia which would activate the hospital Code Blue team or Rapid Response Team. Since the opening of the facility in 2006, there had been no reported adverse events during transport from the Emergency Department. An extensive literature search was done to validate the use of RN’s during transport of all patients admitted with telemetry orders. <br/><br/>Results: The literature review supported that the transport of low risk chest pain patients, (as defined by the AHA Scientific Statement), by non-clinical staff is a safe practice. Based on the evidence, a new policy for the transport of all telemetry patients was drafted and initiated in August, 2010. Patients meeting the following criteria may be transported by an ED tech with a remote telemetry box: patients admitted to a medical bed with remote telemetry; patients with permanent, rate controlled atrial fibrillation; stable patients with chronic PVC’s; terminally ill patients who are not candidates for arrhythmia therapy; and patients who are admitted for respiratory ailments such as asthma or pneumonia without underlying cardiac disease. <br/><br/>Implications: It is estimated that it takes approximately 20 minutes per admission for an RN to transport telemetry patients, often leaving sicker patients in the ED without a nurse. The change in practice has improved patient flow, reduced waiting times in the ED and improved staff satisfaction.<br/><br/><br/><br/><br/><br/><br/><br/><br/><br/><br/>en_GB
dc.date.available2011-12-21T12:46:54Z-
dc.date.issued2011-12-21T12:46:54Z-
dc.date.accessioned2011-12-21T12:46:54Z-
dc.conference.date2011en_US
dc.conference.nameENA Annual Conference 2011en_US
dc.conference.hostEmergency Nurses Associationen_US
dc.description.noteItem supplied by the event sponsor in abstract-only format. Please contact the author(s) (if contact information is listed) and/or the event sponsor to obtain a full-text copy of this item.-
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