Department of Nursing, Bethel University, St Paul, Minnesota 55113, USA.
Am J Crit Care. 2010 Mar;19(2):112-23. doi: 10.4037/ajcc2010264.
Continuous ST-segment monitoring can be used to detect early and transient cardiac ischemia. The American Heart Association and American Association of Critical-Care Nurses recommend its use among specific patients, but such monitoring is routine practice in only about half of US hospitals.
To determine cardiologists' awareness and practice standards regarding continuous ST-segment monitoring and the physicians' perceptions of appropriate patient selection, benefits and barriers, and usefulness of this technology.
An electronic survey was sent to a random sample of 915 US cardiologists from a pool of 4985 certified cardiologists.
Of 200 responding cardiologists, 55% were unaware of the consensus guidelines. Of hospitals where respondents admitted patients, 49% had a standard of practice for using continuous ST-segment monitoring for cardiac patients. Most cardiologists agreed or strongly agreed that patients in the cardiovascular laboratory (87.5%) and intensive care unit (80.5%) should have such monitoring. Cardiologists routinely ordered ST monitoring for patients with acute coronary syndrome (67%) and after percutaneous coronary intervention (60%). The primary factor associated with higher perceptions for benefits, clinical usefulness, and past use of continuous ST-segment monitoring was whether or not hospitals in which cardiologists practiced had a standard of practice for using this monitoring. A secondary factor was awareness of published consensus guidelines for such monitoring.
Respondents (55%) were unaware of published monitoring guidelines. Hospital leaders could raise awareness by multidisciplinary review of evidence and possibly incorporating continuous ST-segment monitoring into hospitals' standards of practice.
连续 ST 段监测可用于检测早期和短暂性心肌缺血。美国心脏协会和美国危重病护理护士协会建议在特定患者中使用这种监测，但这种监测在大约一半的美国医院中是常规做法。
确定心脏病专家对连续 ST 段监测的认识和实践标准，以及医生对合适患者选择、益处和障碍以及该技术有用性的看法。
对来自 4985 名认证心脏病专家库的 915 名美国心脏病专家进行了电子调查。
在 200 名回应的心脏病专家中，有 55%不知道共识指南。在接受受访者入院的医院中，有 49%有使用连续 ST 段监测的标准做法。大多数心脏病专家同意或强烈同意心血管实验室（87.5%）和重症监护病房（80.5%）的患者应该进行这种监测。心脏病专家常规为急性冠状动脉综合征（67%）和经皮冠状动脉介入治疗（60%）患者下达 ST 监测医嘱。与更高的益处、临床有用性和过去使用连续 ST 段监测的感知相关的主要因素是心脏病专家执业的医院是否有使用这种监测的标准做法。第二个因素是对这种监测的已发表共识指南的认识。
受访者（55%）不知道已发布的监测指南。医院领导可以通过多学科审查证据来提高认识，并可能将连续 ST 段监测纳入医院的标准做法中。
