Neil H. Winawer, MD, SFHM reviewing Palchaudhuri S et al. J Hosp Med 2017 Jun.
A retrospective study shows that telemetry watchers reduced nursing burden by intercepting many nonactionable alarms.
Cardiac telemetry monitoring is used widely to detect clinically significant arrhythmias in hospitalized patients; however, such monitoring is resource intensive and often produces nonactionable alarms. Monitor watchers (certified medical assistants with additional telemetry training) sometimes are deployed centrally to triage telemetry alerts, which enables nurses to focus on other clinical tasks. But is this a useful practice?
Researchers retrospectively studied approximately 1200 telemetry patients (not in the intensive care unit) at an urban teaching hospital during 2 months. A daily average of 66 telemetry patients generated five system alerts per patient-day (i.e., ≈1 alert every 4 minutes). Nonactionable alarms were defined as invalid (e.g., motion artifact) or nuisance (e.g., known sinus tachycardia) warnings. If a monitor watcher did not intercept an alarm, a text message was sent automatically to nurses. During the study period, more than 20,000 alerts were generated, 87% of which were intercepted by monitor watchers. Although a third of all alerts signaled potentially lethal conditions, none triggered code team activation.
Palchaudhuri S et al. Telemetry monitor watchers reduce bedside nurses' exposure to alarms by intercepting a high number of nonactionable alarms. J Hosp Med 2017 Jun; 12:447.