Risk Management: Updating telemetry practices to improve the culture of safety
Marietta P. Stanton PhD, RN-BC, CCN, CMAC, CNL, NEA-BC
Lynn Whelan DNP, RN, NEA-BC, ONC

$3.95 		Nursing Management
March 2013 
Volume 44  Number 3
Pages 12 - 14
 
  PDF Version Available!

ABSTRACT
The focus of telemetry monitoring is on detection of significant dysrhythmias rather than acute coronary syndrome.1 A centralized telemetry system, in which cardiac monitoring of patients is performed utilizing telemetry monitor technicians, is one way of ensuring that patients are safely monitored.2 Technical and clinical processes should be evaluated and assessed for effectiveness and opportunities for improvements. Technical processes consist of the equipment utilized to perform the monitoring, the broadcast frequency of the system, and identifying which areas of the hospital should have telemetry coverage. Clinical processes related to telemetry monitoring include policies, protocol, and staffing. (See Figure 1.)Executive leadership for one of the largest health systems in Georgia requested that cardiac leaders form a team to evaluate the current telemetry system for improvements and possible replacement. The request was made due to consistent problems with connectivity and lack of complete coverage areas in the hospitals. The healthcare system consists of six hospitals, with a total of 1,830 licensed beds. The system has the capacity to monitor 500 patients on telemetry. A multidisciplinary team was formed to evaluate the effectiveness and utilization of telemetry monitoring. Team members included nurses, physicians, biomedical personnel, information systems staff, purchasing, and cardiac monitor technicians.The telemetry team performed a review of deidentified incident reports over a 12-month period, which revealed a total of 96 incidents related to telemetry. Incident reports are completed by the nursing staff whenever there's a concern regarding safe patient care or a lack of policy adherence. Five common themes were identified from the review of the incidents: telemetry orders weren't initiated, the wrong patients were being monitored, there were delays in response to the monitor technician by the nursing staff, arrhythmia weren't being recognized by staff,

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