BACKGROUND: In 55% of progressive care units, someone is assigned to watch the cardiac monitors at all times, but the effect of this practice on patients' outcomes has not been examined. OBJECTIVE: To evaluate the effect of continual observation of telemetry units by a monitor watcher on mortality, frequency of transfer to a critical care unit, and the occurrence of five life-threatening dysrhythmias. METHODS: Data for this quasi-experimental study were collected on 1185 patients for a 9-month period in 1993 when the cardiac progressive care unit had a monitor watcher and on 1198 patients for a 9-month period in 1994 when the unit had no monitor watcher. RESULTS: We found no significant differences in mortality, frequency of transfer to a critical care unit, or the occurrence of three of the five dysrhythmias examined. The presence of a monitor watcher was associated with significantly fewer episodes of sustained ventricular tachycardia but more bradyarrhythmias. For both sustained ventricular tachycardia and bradyarrhythmias, the monitor watcher variable remained in the final multivariate logistic regression models. CONCLUSIONS: The presence of a monitor watcher was not associated with lower rates of most adverse outcomes evaluated; however, fewer episodes of sustained ventricular tachycardia occurred when a monitor watcher was present. Sustained ventricular tachycardia is life-threatening, disturbing to the patient, and may result in a longer hospital stay while medical therapy is being adjusted. The results of this study support the use of a monitor watcher to prevent sustained ventricular tachycardia.
BACKGROUND: In 55% of progressive care units, someone is assigned to watch the cardiac monitors at all times, but the effect of this practice on patients' outcomes has not been examined. OBJECTIVE: To evaluate the effect of continual observation of telemetry units by a monitor watcher on mortality, frequency of transfer to a critical care unit, and the occurrence of five life-threatening dysrhythmias. METHODS: Data for this quasi-experimental study were collected on 1185 patients for a 9-month period in 1993 when the cardiac progressive care unit had a monitor watcher and on 1198 patients for a 9-month period in 1994 when the unit had no monitor watcher. RESULTS: We found no significant differences in mortality, frequency of transfer to a critical care unit, or the occurrence of three of the five dysrhythmias examined. The presence of a monitor watcher was associated with significantly fewer episodes of sustained ventricular tachycardia but more bradyarrhythmias. For both sustained ventricular tachycardia and bradyarrhythmias, the monitor watcher variable remained in the final multivariate logistic regression models. CONCLUSIONS: The presence of a monitor watcher was not associated with lower rates of most adverse outcomes evaluated; however, fewer episodes of sustained ventricular tachycardia occurred when a monitor watcher was present. Sustained ventricular tachycardia is life-threatening, disturbing to the patient, and may result in a longer hospital stay while medical therapy is being adjusted. The results of this study support the use of a monitor watcher to prevent sustained ventricular tachycardia.
Authors: Jonathan S Steinberg; Niraj Varma; Iwona Cygankiewicz; Peter Aziz; Paweł Balsam; Adrian Baranchuk; Daniel J Cantillon; Polychronis Dilaveris; Sergio J Dubner; Nabil El-Sherif; Jaroslaw Krol; Malgorzata Kurpesa; Maria Teresa La Rovere; Suave S Lobodzinski; Emanuela T Locati; Suneet Mittal; Brian Olshansky; Ewa Piotrowicz; Leslie Saxon; Peter H Stone; Larisa Tereshchenko; Mintu P Turakhia; Gioia Turitto; Neil J Wimmer; Richard L Verrier; Wojciech Zareba; Ryszard Piotrowicz Journal: Ann Noninvasive Electrocardiol Date: 2017-05 Impact factor: 1.468
Authors: Christopher P Bonafide; A Russell Localio; John H Holmes; Vinay M Nadkarni; Shannon Stemler; Matthew MacMurchy; Miriam Zander; Kathryn E Roberts; Richard Lin; Ron Keren Journal: JAMA Pediatr Date: 2017-06-01 Impact factor: 16.193
Authors: Kathleen C Buckwalter; Margaret Grey; Barbara Bowers; Ann Marie McCarthy; Deborah Gross; Marjorie Funk; Cornelia Beck Journal: Res Nurs Health Date: 2009-02 Impact factor: 2.228
Authors: Noa Segall; Jeffrey A Joines; Ron'Nisha D Baldwin; Diane Bresch; Lauren G Coggins; Suzanne Janzen; Jill R Engel; Melanie C Wright Journal: Simul Healthc Date: 2022-04-01 Impact factor: 1.929