title: The frequency of electrocardiographic errors due to electrode cable switches: a before and after study.
abstract: BACKGROUND
  Electrocardiographic (ECG) errors due to electrode cable reversal confuse physicians and provoke unnecessary diagnostic tests. They occur in approximately 4% of ECGs performed in the intensive care unit (ICU). We aimed to investigate whether this frequency could be reduced by an appropriate intervention.
  
  
  METHODS
  All ECGs from consecutive patients were collected at ICU discharge and analyzed by the investigators. Before collecting a second set of ECGs, we educated our ICU staff and performed technical improvements on the electrocardiographs (system approach). Electrocardiographic errors were identified applying previously published morphologic criteria.
  
  
  RESULTS
  We collected and analyzed 1123 ECGs from 416 patients. Nine hundred ten ECGs (81%) were recorded in the ICU; and the frequencies of electrode cable misplacements before and after the intervention were 4.8% and 1.2%, respectively (P = .002).
  
  
  CONCLUSIONS
  Using a system approach, we were able to significantly reduce the frequency of ECG errors due to electrode cable switches by 75%.
authors.affiliation: Department of Cardiology, Canton Hospital Sankt Gallen, Rorschacher Strasse 95, Sankt Gallen, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thaler
authors.forename: Volker
authors.initials: V
authors.lastname: Tempelmann
authors.forename: Marco
authors.initials: M
authors.lastname: Maggiorini
authors.forename: Alain
authors.initials: A
authors.lastname: Rudiger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D004562:Electrocardiography / Q000295:instrumentation* / Q000706:statistics & numerical data*; D004566:Electrodes / Q000706:statistics & numerical data*; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011361:Professional Competence / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology