Cardiac telemetry is widely used in hospitals, but it is expensive and labor-intensive. Therefore, it should be used only in those most likely to benefit. The authors review the available evidence and offer their recommendations.
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Understanding provider use of a new clinical decision support tool aimed at reducing excess telemetry in an academic health system: A retrospective study.
J Eval Clin Pract
September 2024
Department of Medicine, NYU Langone Health, Brooklyn, New York, USA.
Rationale: Cardiac monitoring has often been identified as an area of overutilization and remains a limited resource in many hospitals. With the aim of reducing telemetry overuse, we added clinical decision support to our health system's telemetry order with guidance on appropriate indications for monitoring. The new order requires selection of an appropriate clinical indication.
View Article and Find Full Text PDFUtility of short-term telemetry heart rhythm monitoring and CHADS-VASc stratification in patients presenting with suspected cerebrovascular accident.
World J Cardiol
February 2023
Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11553, United States.
Background: Inpatient telemetry heart rhythm monitoring overuse has been linked to higher healthcare costs.
Aim: To evaluate if CHADS-VASc score could be used to indicate if a patient admitted with possible cerebrovascular accident (CVA) or transient ischemic attack (TIA) requires inpatient telemetry monitoring.
Methods: A total of 257 patients presenting with CVA or TIA and placed on telemetry monitoring were analyzed retrospectively.
Tell-a provider about tele: Reducing overuse of telemetry across 10 hospitals in a safety net system.
J Hosp Med
February 2023
Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Background: Telemetry is often a scarce resource at hospitals and is important for arrhythmia and myocardial ischemia detection. Overuse of telemetry monitoring leads to alarm fatigue resulting in failure to respond to arrhythmias, patient harm, and possible unnecessary testing.
Methods: This quality improvement initiative was implemented across NYC Health and Hospitals, an 11-hospital urban safety net system.
Evaluation of a Multifaceted Protocol in Reducing Unnecessary Telemetry Monitoring across a Large Healthcare System.
South Med J
December 2022
From the Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Objectives: Telemetry is frequently overused in hospitals. The goal of this study was to evaluate a telemetry protocol aimed at decreasing inappropriate telemetry utilization across four different hospitals within a large healthcare system by modifying the electronic telemetry order to incorporate the 2017 American Heart Association practice guidelines on the appropriate use of telemetry and using an electronic nursing screening task form to safely discontinue telemetry.
Methods: We performed a retrospective analysis of telemetry utilization before and after we implemented a protocol across four hospitals within a large healthcare system.
Decreasing Inappropriate Telemetry Use via Nursing-Driven Checklist and Electronic Health Record Order Set.
Cureus
September 2022
Hospital Medicine Group, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, USA.
Introduction: Telemetry is ubiquitous in many hospitals despite widely acknowledged limitations, waste, and potential harm associated with inappropriate use. To curb overuse, guidelines such as the 2017 American Heart Association/American College of Cardiology (AHA/ACC) continuous telemetry monitoring practice standards have outlined appropriate telemetry use standards. This study aimed to perform two "plan-do-study-act" (PDSA) cycles and assess whether a nursing (RN)-driven checklist addressing appropriate telemetry use, combined with just-in-time education delivered via an electronic health record (EHR) order set modification, was efficacious in reducing inappropriate telemetry use within a level 1a Veterans Health Administration hospital.
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