Marjorie Funk is the Helen Porter Jayne and Martha Prosser Jayne Professor Emerita of Nursing, Yale School of Nursing, West Haven, Connecticut.
Kristopher P. Fennie is an assistant professor of epidemiology, New College of Florida, Sarasota, Florida.
Am J Crit Care. 2021 Jan 1;30(1):38-44. doi: 10.4037/ajcc2021122.
Electrocardiographic telemetry monitors are ubiquitous in hospitals. Dedicated monitor watchers, either on the unit or in a centralized location, are often responsible for observing telemetry monitors and responding to their alarms. The impact of use of monitor watchers is not known.
To evaluate the association of monitor-watcher use with (1) nurses' knowledge of electrocardiographic (ECG) monitoring and (2) accuracy of arrhythmia detection.
Baseline data from 37 non-intensive care unit cardiac patient care areas in 17 hospitals in the Practical Use of the Latest Standards for Electrocardiography trial were analyzed. Nurses' knowledge (n = 1136 nurses) was measured using a validated, 20-item online test. Accuracy of arrhythmia detection (n = 1189 patients) was assessed for 5 consecutive days by comparing arrhythmias stored in the monitor with nurses' documentation. Multiple regression was used to evaluate the association of use of monitor watchers with scores on the ECG-monitoring knowledge test. The association of monitor-watcher use with accuracy of arrhythmia detection was examined by χ2 analysis.
Of the 37 units, 13 (35%) had monitor watchers. Use of monitor watchers was not independently associated with ECG-monitoring knowledge (P = .08). The presence of monitor watchers also was not significantly associated with the accuracy of arrhythmia detection (P = .94).
Although the use of monitor watchers was not associated with diminished nurses' knowledge of ECG monitoring, it also was not associated with more accurate arrhythmia detection. If implementing a monitor-watcher program, critical safety points, such as ensuring closed-loop communication, must be considered.
心电图遥测监测器在医院中无处不在。专门的监测器观察者，无论是在病房还是在集中位置，通常负责观察遥测监视器并对其警报做出反应。使用监测器观察者的效果尚不清楚。
评估使用监测器观察者与（1）护士对心电图（ECG）监测的知识（2）心律失常检测的准确性之间的关联。
对实用最新心电图标准试验中 17 家医院的 37 个非重症监护病房心脏患者护理区域的基线数据进行了分析。使用经过验证的 20 项在线测试来衡量护士的知识（n = 1136 名护士）。通过将监视器中存储的心律失常与护士的记录进行比较，连续 5 天评估心律失常检测的准确性（n = 1189 名患者）。使用多元回归分析评估使用监测器观察者与 ECG 监测知识测试得分之间的关联。使用 χ2 分析检查监测器观察者使用与心律失常检测准确性之间的关联。
在 37 个单位中，有 13 个（35％）有监测器观察者。使用监测器观察者与 ECG 监测知识之间没有独立的关联（P =.08）。监测器观察者的存在与心律失常检测的准确性也没有显著相关（P =.94）。
尽管使用监测器观察者与护士对 ECG 监测的知识减少无关，但它也与更准确的心律失常检测无关。如果实施监测器观察者计划，必须考虑到关键的安全要点，例如确保闭环通信。
