Accuracy of detection of clinically important dysrhythmias with and without a dedicated monitor watcher.

BACKGROUND

Although dedicated monitor watchers are used in many progressive care units with telemetry monitors, this costly practice has not been evaluated.

OBJECTIVE

To compare the accuracy of detection of clinically important dysrhythmias with and without a dedicated monitor watcher.

METHODS

On a 26-bed cardiac progressive care unit, documentation of four categories of dysrhythmias during a 7-week period when a monitor watcher was present was compared with that during a 7-week period when no monitor watcher was present. The Hewlett-Packard CareVue Clinical Event Review, a full-disclosure system, was used as the gold standard.

RESULTS

Accuracy of detection of nonsustained ventricular tachycardia, supraventricular tachycardia, and pauses was significantly better with a monitor watcher than without. Although the detection of life-threatening rhythms was correct a higher percentage of the time with a monitor watcher, the difference was not significant.

CONCLUSIONS

The efficiency and quality of patient care can be enhanced by using a dedicated monitor watcher. The results of this study raise the question of whether improved accuracy of detection of dysrhythmias results in better outcomes for patients.