Survey of use of ST-segment monitoring in patients with acute coronary syndromes.
BACKGROUND
Although effective for assessing ongoing myocardial ischemia, ST-segment monitoring may be underused.


OBJECTIVE
To determine the proportion of cardiac units in the United States that use ST-segment monitoring, hospital and unit characteristics associated with its use, how units use such monitoring with respect to research recommendations, if units that use ST-segment monitoring find it clinically useful and easy to use, and why some units are not using this type of monitoring.


METHODS
A survey on ST-segment monitoring was mailed to a random sample of 500 cardiac nurse managers and clinical nurse specialists.


RESULTS
Of the final 192 respondents, 104 (54.2%) reported that they were using ST-segment monitoring. Monitor brand was the only characteristic associated with use of this monitoring (P = .03). On units that used ST-segment monitoring, patients were monitored if they had myocardial infarction (81%), unstable angina (79.6%), or possible myocardial infarction (78.6%) and after percutaneous transluminal coronary angioplasty (47.6%). Leads were chosen according to unit protocol (60.2%) and 12-lead electrocardiographic findings (48.5%); leads II (95.0%) and V1 (75.2%) were used most often. The majority of units that use ST-segment monitoring agreed that it is clinically useful (83%) and easy to use (56%). Among the units not using ST-segment monitoring, the most common reason was that physicians were not interested (27.1%).


CONCLUSIONS
ST-segment monitoring is not routinely used; when it is, research recommendations are often not followed. Increased awareness is needed among cardiac nurses and physicians of the clinical usefulness and proper use of ST-segment monitoring.
Patton
J A
JA
Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md., USA.
Funk
M
M
D000208:Acute Disease; D002300:Cardiac Care Facilities; D015986:Confounding Factors, Epidemiologic; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D014481:United States