J A Patton1, M Funk. 1. Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md., USA.
Abstract
BACKGROUND: Although effective for assessing ongoing myocardial ischemia, ST-segment monitoring may be underused. OBJECTIVES: To determine the proportion of cardiac units in the United States that use ST-segment monitoring, hospital and unit characteristics associated with its use, how units use such monitoring with respect to research recommendations, if units that use ST-segment monitoring find it clinically useful and easy to use, and why some units are not using this type of monitoring. METHODS: A survey on ST-segment monitoring was mailed to a random sample of 500 cardiac nurse managers and clinical nurse specialists. RESULTS: Of the final 192 respondents, 104 (54.2%) reported that they were using ST-segment monitoring. Monitor brand was the only characteristic associated with use of this monitoring (P = .03). On units that used ST-segment monitoring, patients were monitored if they had myocardial infarction (81%), unstable angina (79.6%), or possible myocardial infarction (78.6%) and after percutaneous transluminal coronary angioplasty (47.6%). Leads were chosen according to unit protocol (60.2%) and 12-lead electrocardiographic findings (48.5%); leads II (95.0%) and V1 (75.2%) were used most often. The majority of units that use ST-segment monitoring agreed that it is clinically useful (83%) and easy to use (56%). Among the units not using ST-segment monitoring, the most common reason was that physicians were not interested (27.1%). CONCLUSIONS: ST-segment monitoring is not routinely used; when it is, research recommendations are often not followed. Increased awareness is needed among cardiac nurses and physicians of the clinical usefulness and proper use of ST-segment monitoring.
BACKGROUND: Although effective for assessing ongoing myocardial ischemia, ST-segment monitoring may be underused. OBJECTIVES: To determine the proportion of cardiac units in the United States that use ST-segment monitoring, hospital and unit characteristics associated with its use, how units use such monitoring with respect to research recommendations, if units that use ST-segment monitoring find it clinically useful and easy to use, and why some units are not using this type of monitoring. METHODS: A survey on ST-segment monitoring was mailed to a random sample of 500 cardiac nurse managers and clinical nurse specialists. RESULTS: Of the final 192 respondents, 104 (54.2%) reported that they were using ST-segment monitoring. Monitor brand was the only characteristic associated with use of this monitoring (P = .03). On units that used ST-segment monitoring, patients were monitored if they had myocardial infarction (81%), unstable angina (79.6%), or possible myocardial infarction (78.6%) and after percutaneous transluminal coronary angioplasty (47.6%). Leads were chosen according to unit protocol (60.2%) and 12-lead electrocardiographic findings (48.5%); leads II (95.0%) and V1 (75.2%) were used most often. The majority of units that use ST-segment monitoring agreed that it is clinically useful (83%) and easy to use (56%). Among the units not using ST-segment monitoring, the most common reason was that physicians were not interested (27.1%). CONCLUSIONS: ST-segment monitoring is not routinely used; when it is, research recommendations are often not followed. Increased awareness is needed among cardiac nurses and physicians of the clinical usefulness and proper use of ST-segment monitoring.
Authors: Marjorie Funk; Kristopher P Fennie; Kimberly E Stephens; Jeanine L May; Catherine G Winkler; Barbara J Drew Journal: Circ Cardiovasc Qual Outcomes Date: 2017-02
Authors: Michele M Pelter; Denise L Loranger; Teri M Kozik; Anita Kedia; Richard P Ganchan; Deborah Ganchan; Xiao Hu; Mary G Carey Journal: J Cardiovasc Nurs Date: 2016 Jul-Aug Impact factor: 2.083