Implementing an institution-wide quality improvement policy to ensure appropriate use of continuous cardiac monitoring: a mixed-methods retrospective data analysis and direct observation study
| Autor: | Michael F. Rayo, Traci Mignery, Susan D. Moffatt-Bruce, Jerry Mansfield, Daniel S. Eiferman, Susan White |
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| Rok vydání: | 2015 |
| Předmět: |
Patient Transfer
medicine.medical_specialty Quality management Time Factors medicine.medical_treatment Retrospective data 03 medical and health sciences 0302 clinical medicine Nursing Alarm management medicine Humans 030212 general & internal medicine Hospital Mortality Adverse effect Monitoring Physiologic Retrospective Studies business.industry 030503 health policy & services Health Policy Mortality rate Communication Emergency department Length of Stay Quality Improvement Leadership Outcome and Process Assessment Health Care Emergency medicine Practice Guidelines as Topic Cardiac monitoring 0305 other medical science business Continuous Cardiac Monitoring Emergency Service Hospital |
| Zdroj: | BMJ qualitysafety. 25(10) |
| ISSN: | 2044-5423 |
| Popis: | Background Hospitals have been slow to adopt guidelines from the American Heart Association (AHA) limiting the use of continuous cardiac monitoring for fear of missing important patient cardiac events. A new continuous cardiac monitoring policy was implemented at a tertiary-care hospital seeking to monitor only those patients who were clinically indicated and decrease the number of false alarms in order to improve overall alarm response. Methods Leadership support was secured, a cross-functional alarm management task force was created, and a system-wide policy was developed based on current AHA guidelines. Process measures, including cardiac monitoring rate, monitored transport rate, emergency department (ED) boarding rate and the percentage of false, unnecessary and true alarms, were measured to determine the policy's impact on patient care. Outcome measures, including length of stay and mortality rate, were measured to determine the impact on patient outcomes. Results Cardiac monitoring rate decreased 53.2% (0.535 to 0.251 per patient day, p |
| Databáze: | OpenAIRE |
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