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.
Stukshis
I
I
Yale-New Haven Hospital, New Haven, Conn., USA.
Funk
M
M
Johnson
C R
CR
Parkosewich
J A
JA
D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D002300:Cardiac Care Facilities; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D009511:New England; D009741:Nursing Staff, Hospital; D010561:Personnel Staffing and Scheduling; D013686:Telemetry / Q000295:instrumentation / Q000379:methods*