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意大利医院中经过培训的护士进行的植入式心律转复除颤器(ICM)植入及远程随访管理:当前实践与护士反馈

ICM Implantation and Remote Follow-Up Management by Trained Nurses in Italian Hospitals: Current Practice and Nurse Feedback.

作者信息

Cervellione Rosario, Fetche Simona, Simoncelli Marzia, Frasnelli Paola, Vargiu Maurizio, Messina Cinzia, Contu Emanuele, Bertazzo Anna, Baccolo Eleonora, Carconi Marco, Cropanese Francesco, Spina Cristina, Montanaro Donato, Mercurio Annalisa, Facchetti Giuliana, Moltrasio Massimo, Baccillieri Stella, Mascioli Giosué, Maines Massimiliano

机构信息

Centro Cardiologico Monzino IRCCS, Milano, Italy.

Azienda Ospedaliero Universitaria Integrata di Verona, Verona, Italy.

出版信息

J Cardiovasc Electrophysiol. 2025 Apr;36(4):741-759. doi: 10.1111/jce.16582. Epub 2025 Jan 29.

Abstract

AIMS

This project aimed to evaluate current practices of trained nurses performing implantable cardiac monitor (ICM) implantations and remote follow-ups in Italy, assessing hospital protocols and nurses' perceptions.

METHODS

An anonymous survey was conducted among 163 trained nurses across 75 Italian hospitals, focusing on their ICM implantation and remote monitoring practices. Data collected included hospital characteristics and protocols, barriers to implementation, and nurses' feedback on their experiences.

RESULTS

Of the 112 respondents (69% response rate), 60% reported that nurses in their hospitals are authorized to perform ICM implantations, and 70% said that they can manage all remote monitoring tasks. Thirty-three (29%) nurses manage all aspects of ICM patient care, including implantation, programming, enrollment in remote monitoring, training, data review, and follow-up. Fifty-five percent of nurses perform a part of ICM implants outside the EP/Cath lab, and for 31%, this is the primary location. 84% of implanter nurses achieved autonomy after < 10 supervised implants. More than 90% of implanter nurses consider ICM implantation rewarding and 96% find it safe and easy with the provided kit. However, only 33% and 17% of nurses had written protocols at their hospital, to guide ICM implantation and remote monitoring, respectively.

CONCLUSIONS

Nurse-led ICM implantation and remote follow-up are becoming established practices in Italy, with many nurses operating independently. Despite this progress, the absence of standard operating procedures limits the widespread adoption of these practices. Clear national and international protocols are essential to enhance nurse training, ensure safe practices, and ultimately improve patient care in ICM management.

摘要

目的

本项目旨在评估意大利受过培训的护士进行植入式心脏监测器(ICM)植入和远程随访的当前做法,评估医院协议和护士的看法。

方法

对意大利75家医院的163名受过培训的护士进行了一项匿名调查,重点是他们的ICM植入和远程监测做法。收集的数据包括医院特征和协议、实施障碍以及护士对其经验的反馈。

结果

在112名受访者(回复率69%)中,60%报告称其所在医院的护士被授权进行ICM植入,70%表示他们可以管理所有远程监测任务。33名(29%)护士负责ICM患者护理的所有方面,包括植入、编程、远程监测登记、培训、数据审查和随访。55%的护士在电生理/导管实验室之外进行部分ICM植入,31%的护士将此作为主要地点。84%的植入护士在接受不到10次监督植入后实现了自主操作。超过90%的植入护士认为ICM植入是有意义的,96%的护士认为使用提供的套件进行植入既安全又容易。然而,分别只有33%和17%的护士所在医院有书面协议来指导ICM植入和远程监测。

结论

在意大利,由护士主导的ICM植入和远程随访正逐渐成为既定做法,许多护士能够独立操作。尽管取得了这一进展,但缺乏标准操作程序限制了这些做法的广泛采用。明确的国家和国际协议对于加强护士培训、确保安全操作并最终改善ICM管理中的患者护理至关重要。

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