Team-Based Approach Can Reduce Cardiac Monitor Alarms
(HealthDay News) — A team-based approach can reduce excessive cardiac monitor alarms, according to a report published online November 10 in Pediatrics.
Christopher E. Dandoy, MD, the from Cincinnati Children's Hospital Medical Center, and colleagues developed and implemented a standardized cardiac monitor care process (CMCP) on a 24-bed pediatric bone marrow transplant unit. The standardized CMCP included a process for initial ordering of monitor parameters; pain-free daily electrode replacement; daily individualized cardiac monitor parameter assessment; and a reliable method for cardiac monitor discontinuation. Changes were designed, tested, and implemented in a Model for Improvement. After testing and adaptation, the following changes were implemented: family/patient engagement in the CMCP; creation of a monitor log; development of a pain-free electrode removal process; and customized monitor delay and threshold parameters.
The researchers observed an increase in the percent compliance with each of the four components of the CMCP from January to November 2013. There was an increase in CMCP overall compliance from a median of 38 to 95%. The median number of alarms per patient-day decreased from 180 to 40 during this period.
"We recommend a team-based approach to monitor care, including individualized assessment of monitor parameters, daily lead change, and proper discontinuation of the monitors," the authors write.