Appropriate Clinical Support of Telemetry Patients Transported from the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/306603
Category:
Abstract
Type:
Poster
Title:
Appropriate Clinical Support of Telemetry Patients Transported from the Emergency Department
Author(s):
Buckley, Barbara A.; Collins, Bethany; Keirman, Heather; Eisenberg, Jodi L.; Ramsey, Kristin; Khare, Rahul
Lead Author STTI Affiliation:
Non-member
Author Details:
Barbara A. Buckley, BSN, RN, bbuckley517@gmail.com; Bethany Collins, BSN, RN, NE-BC; Heather Keirman, MSN, RN; Jodi L. Eisenberg, MHA, CPHQ, CPMSM, CSHA; Kristin Ramsey, MSN, RN, MPPM, NE-BC; Rahul Khare, MD
Abstract:

Evidence-based Practice Abstract

Purpose: Current practice at many healthcare institutions indicates patients admitted for telemetry monitoring from the emergency department to the inpatient units will be transported with a registered nurse and continuous cardiac monitoring. The practice of nurse assisted telemetry transports diverts valuable nursing time and resources from patients currently being cared for in the emergency department, including new patients with undifferentiated illness. The increasing volume and acuity of patients presenting to the emergency department for care warrants the use of evidence based practices to support the most efficient use of patient care resources. The aim of this project was to determine the appropriate clinical support for this patient population and to establish the proper allocation of emergency nursing resources.

Design: Plan-do-study-act quality improvement methods were used.

Setting: This project was conducted at an urban, level I, academic medical center with an annual emergency department volume of over 84,000 patients.

Subjects: All patients who were to be admitted to one pre-identified non-critical care telemetry inpatient unit were screened for appropriate clinical support.

Methods: An extensive literature review was conducted to determine appropriate clinical support for telemetry patients in the emergency department admitted to the inpatient setting. Clear, evidence based criteria has been identified to assist in the classification of low-risk chest pain patients and in recognizing the proper allocation of telemetry monitoring. Based on these findings, a proposal for practice change for telemetry patients admitted from the emergency department to the non-critical care inpatient setting was presented to the chief nursing officer, nursing practice and telemetry committees. Upon approval from the committees, a pilot was proposed and conducted between the emergency department and one inpatient cardiac unit. Over a 3 month period, all patients in the emergency department who were to be admitted to the identified cardiac unit were screened to determine appropriate clinical support utilizing a detailed screening tool. Patients who met criteria for low-risk transport were transported with non-clinical personnel on a portable telemetry box to the receiving inpatient unit.

Results/Outcomes: Over 700 patients were screened, 88% met criteria for low-risk transport on a portable telemetry box without RN clinical support. There were no adverse events. Over 19 hours per week of nursing time was saved from being diverted off unit for transport.

Implications: The use of evidence based practices to ensure the proper allocation of nursing resources in the emergency department would prove to be more beneficial for the patient safety and satisfaction of many and be a fiscally responsible provision of valuable nursing resources to care for patients in the emergency department rather than off unit transporting low-risk telemetry patients to the inpatient setting.

Keywords:
Transport of Telemetry Patients from ED
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Center
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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleAppropriate Clinical Support of Telemetry Patients Transported from the Emergency Departmenten_GB
dc.contributor.authorBuckley, Barbara A.en_GB
dc.contributor.authorCollins, Bethanyen_GB
dc.contributor.authorKeirman, Heatheren_GB
dc.contributor.authorEisenberg, Jodi L.en_GB
dc.contributor.authorRamsey, Kristinen_GB
dc.contributor.authorKhare, Rahulen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsBarbara A. Buckley, BSN, RN, bbuckley517@gmail.com; Bethany Collins, BSN, RN, NE-BC; Heather Keirman, MSN, RN; Jodi L. Eisenberg, MHA, CPHQ, CPMSM, CSHA; Kristin Ramsey, MSN, RN, MPPM, NE-BC; Rahul Khare, MDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306603-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: Current practice at many healthcare institutions indicates patients admitted for telemetry monitoring from the emergency department to the inpatient units will be transported with a registered nurse and continuous cardiac monitoring. The practice of nurse assisted telemetry transports diverts valuable nursing time and resources from patients currently being cared for in the emergency department, including new patients with undifferentiated illness. The increasing volume and acuity of patients presenting to the emergency department for care warrants the use of evidence based practices to support the most efficient use of patient care resources. The aim of this project was to determine the appropriate clinical support for this patient population and to establish the proper allocation of emergency nursing resources.</p><p>Design: Plan-do-study-act quality improvement methods were used. </p><p>Setting: This project was conducted at an urban, level I, academic medical center with an annual emergency department volume of over 84,000 patients.</p><p>Subjects: All patients who were to be admitted to one pre-identified non-critical care telemetry inpatient unit were screened for appropriate clinical support.</p><p>Methods: An extensive literature review was conducted to determine appropriate clinical support for telemetry patients in the emergency department admitted to the inpatient setting. Clear, evidence based criteria has been identified to assist in the classification of low-risk chest pain patients and in recognizing the proper allocation of telemetry monitoring. Based on these findings, a proposal for practice change for telemetry patients admitted from the emergency department to the non-critical care inpatient setting was presented to the chief nursing officer, nursing practice and telemetry committees. Upon approval from the committees, a pilot was proposed and conducted between the emergency department and one inpatient cardiac unit. Over a 3 month period, all patients in the emergency department who were to be admitted to the identified cardiac unit were screened to determine appropriate clinical support utilizing a detailed screening tool. Patients who met criteria for low-risk transport were transported with non-clinical personnel on a portable telemetry box to the receiving inpatient unit.</p><p>Results/Outcomes: Over 700 patients were screened, 88% met criteria for low-risk transport on a portable telemetry box without RN clinical support. There were no adverse events. Over 19 hours per week of nursing time was saved from being diverted off unit for transport.</p><p>Implications: The use of evidence based practices to ensure the proper allocation of nursing resources in the emergency department would prove to be more beneficial for the patient safety and satisfaction of many and be a fiscally responsible provision of valuable nursing resources to care for patients in the emergency department rather than off unit transporting low-risk telemetry patients to the inpatient setting.</p>en_GB
dc.subjectTransport of Telemetry Patients from EDen_GB
dc.date.available2013-12-09T17:00:36Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T17:00:36Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Centeren_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.en_GB
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