Issues related to cardiac monitoring on an orthopaedic unit.

Nurses on a variety of medical surgical units are being asked to care for patients being monitored for cardiac dysrhythmias. Basic information needed by nurses caring for these patients includes understanding the fundamentals of cardiac monitoring such as the components of the cardiac cycle and electrode placement. A working knowledge of cardiac dysrhythmia interpretation is essential. Protocols for emergent treatment of dysrhythmias must be in place, and a program for maintaining proficiency should be developed. Yearly refresher programs can be provided, including validation of dysrhythmia interpretation skills and problem solving of case-based scenarios. Any program supporting development and maintenance of a skill such as cardiac monitoring requires ongoing validation.