title: Development of evidence-based remote telemetry policy guidelines for a multifacility hospital system.
abstract: Over 10 years ago, the standards for cardiac monitoring were set forth by the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young. The standards were endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical-Care Nurses. The American Heart Association printed the standards as an American Heart Association Scientific Statement. The standards provided direction related to remote telemetry monitoring to acute care hospitals. Since the standards were published, remote monitoring of cardiac patients has increased dramatically prompting research and literature related to appropriate utilization. Appropriate and safe telemetry monitoring requires clearly written evidence-based facility policies. This article describes the process whereby a team of Veterans Hospital Administration nurses from across the country reviewed 70 remote telemetry policies representing 75 Veterans Hospital Administration hospitals for clarity, consistency, and congruency to existing levels of evidence found in the literature. This article describes the processes, successes, and challenges of compiling an evidence-based remote telemetry policy guideline.
authors.affiliation: Karen J. George, DNP, RN, CEN, VHA-CM, is Nurse III Clinician at James H. Quillen VAMC, Mountain Home, Tennessee. Her background includes years as a clinical educator, staff nurse in critical, trauma, open-heart, and emergency nursing. She serves as a national Ambassador for American Association of Critical Care Nurses. Colleen Walsh-Irwin, DNP, RN, ANP, CCRN, is the cardiovascular clinical nurse advisor for the Department of Veterans Affairs. She has an extensive cardiac nursing background and currently works as a cardiology nurse practitioner. Caleb Queen, MBA, BSN, RN, CCRN, has extensive experience as an ER, CVICU and SICU nurse. He currently works for the Department of Veterans Affairs at the Charles George VAMC in Asheville, NC in the SICU and serves on the Cardiovascular Field Advisory Committee for the Office of Nursing Services in Washington, DC. Kimberly Vander Heuvel, ARNP, MS, CCRN, is nurse practitioner certified in Acute Care since 1999. Her background predominantly in cardiology with special interest in Electrophysiology and critical care. Certified as an Adult CCRN for 20 years. Carrie Hawkins, MSN, RN,CCRN, has worked for Eastern Colorado Health Care System (ECHCS) for the past ten years. She has extensive surgical and medical ICU experience and managed VISN 19's Virtual ICU program. She is currently the manager of the post-surgical/telemetry unit as well as the interim manager of ECHCS's telemetry program. Susan Roberts, MSN, ANP-BC, RN, an adult nurse practitioner at Durham VAMC, Durham, North Carolina. Her background includes nursing education at Indiana University Northwest; private practice in Indiana and Florida, and more recently at the Durham VAMC in the Cardiology section. Susan has served on Six Sigma and System Redesign teams for the Durham VA and other regional VA Medical Centers in areas of gastroenterology, radiology, podiatry, and nephrology.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: George
authors.forename: Colleen
authors.initials: C
authors.lastname: Walsh-Irwin
authors.forename: Caleb
authors.initials: C
authors.lastname: Queen
authors.forename: Kimberly Vander
authors.initials: KV
authors.lastname: Heuvel
authors.forename: Carrie
authors.initials: C
authors.lastname: Hawkins
authors.forename: Susan
authors.initials: S
authors.lastname: Roberts
mesh_terms: D002309:Cardiology / Q000592:standards*; D004562:Electrocardiography / Q000592:standards*; D006801:Humans; D008991:Monitoring, Physiologic / Q000451:nursing* / Q000592:standards*; D009096:Multi-Institutional Systems; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D013686:Telemetry; D014481:United States