Course Information
Educational Need
The first “electrokardiogram (EKG)” was invented in 1902 and since that time, usage of “electrocardiograms (ECG)” has become standard practice for the monitoring of cardiac rhythms in hospitalized patients. Research has shown that nurses do not appropriately monitor patients using ECG: Arrhythmia monitoring is over-utilized while ischemia and QT interval monitoring is underused in current clinical practice. Specifically, a recent multi-site randomized clinical trial found that 85% of patients with no indication for arrhythmia are being monitored while only 21% of patients with an indication for QT interval monitoring and 35% of hospitalized patients with an indication for ischemia were actually monitored. These statistics indicate that nurses and telemetry technicians need additional education regarding the American Heart Association Practice Standards for ECG Monitoring in Hospital Settings.
An educational need has been identified for a continuing education activity on the American Heart Association Practice Standards for ECG monitoring in hospital settings. Specifically, this activity will review the basics of ECG analysis, indications for ECG monitoring, and strategies to improve the quality of ECG monitoring. This one-hour online continuing education activity is recommended for nurses and telemetry technicians.
Overview
The usage of “electrocardiograms (ECG)” has become standard practice for the monitoring of cardiac rhythms in hospitalized patients. However, research has shown that healthcare professionals do not appropriately monitor patients using ECG: Arrhythmia monitoring is over utilized while ischemia and QT interval monitoring is underused in current clinical practice. This activity will assist nurses and telemetry technicians improve practice regarding ECG monitoring by reviewing recommendations provided in the American Heart Association Practice Standards for ECG Monitoring in Hospital Settings.
Learning Outcome / Objectives
After completing this continuing education activity, nurses and telemetry technicians will be able to monitor patients using ECG to comply with the American Heart Association Practice Standards for ECG Monitoring in Hospital Settings. Specifically, they will be able to (1) evaluate and analyze ECG rhythms; (2) cite indications for ECG monitoring; and (3) apply strategies to improve the quality of ECG monitoring.
Outline
- Cardiac Monitoring Lead Systems
- ECG Analysis
- The ECG waveform
- Determining the heart rate
- Evaluating the ventricular rhythm
- Identifying the P wave morphology
- Determining the P-R interval
- Identifying the QRS complex
- Indications for ECG Monitoring
- Cardiac arrhythmias
- ST-segment ischemia monitoring
- QT interval monitoring
- Improving the Quality of ECG Monitoring
- Skin preparation
- Electrode quality, application, skin contact
- Artifact elimination
- Lead selection and placement
- Tailoring alarm parameters
- Documentation
