Toronto General Hospital, University Health Network and the Toronto Congenital Cardiac Centre for Adults, University of Toronto, Ontario, Canada.
Am J Crit Care. 2010 Mar;19(2):124-33; quiz 134. doi: 10.4037/ajcc2010877.
The practice standard for electrocardiographic monitoring in hospitals recommends use of atrial electrograms after cardiac surgery to help diagnose cardiac arrhythmias.
To determine whether use of atrial electrograms significantly improves nurses' ability to diagnose cardiac arrhythmias and to assess nurses' perceptions of the ease of obtaining and interpreting electrograms, the frequency of use of atrial electrograms, and the correlation between nurses' experience with the technique and arrhythmia scores.
In total, 282 nurses completed a test consisting of 5 electrocardiographic rhythms for which use of atrial electrograms might improve interpretation. A standardized educational session on obtaining and interpreting atrial electrograms was given to 165 nurses who had not previously received such education. In a second test, the same rhythms were provided along with atrial electrograms to 261 nurses. Overall changes in total test scores and individual changes in interpreting rhythms were analyzed. Demographic information, perceptions of the ease of obtaining and interpreting atrial electrograms, and the frequency of use were collected. Correlation between scores on the second test and nurses' years of experience in interpreting atrial electrograms was determined.
Use of atrial electrograms significantly increased overall arrhythmia interpretation scores. Nurses rated obtaining atrial electrograms as easy and interpreting the findings as moderately easy. Despite this reported ease, 57.1% of nurses obtained atrial electrograms less than monthly and only 3.4% obtained them daily. Correlation between experience with atrial electrograms and arrhythmia test scores was not significant.
Nurses' use of atrial electrograms improves diagnoses of cardiac arrhythmias.
医院的心电图监测实践标准建议在心脏手术后使用心房电图来帮助诊断心律失常。
确定使用心房电图是否能显著提高护士诊断心律失常的能力，并评估护士对获取和解释心电图的难易程度、心房电图的使用频率、护士使用该技术的经验与心律失常评分之间的相关性的看法。
共有 282 名护士完成了一项包含 5 种可能因使用心房电图而改善解释的心电图节律的测试。对 165 名未接受过此类教育的护士进行了关于获取和解释心房电图的标准化教育课程。在第二次测试中，向 261 名护士提供了相同的节律和心房电图。分析了总测试分数的总体变化和解释节律的个别变化。收集了人口统计学信息、对获取和解释心房电图的难易程度的看法以及使用频率。确定了第二次测试的分数与护士解释心房电图的年限之间的相关性。
使用心房电图显著提高了整体心律失常解释分数。护士认为获取心房电图很容易，解释结果也比较容易。尽管如此，57.1%的护士每月获取心房电图的次数少于一次，只有 3.4%的护士每天获取心房电图。心房电图使用经验与心律失常测试分数之间没有显著相关性。
护士使用心房电图可改善心律失常的诊断。
