title: Cardiac monitoring: Hospital-wide education and staff competence.
abstract: BACKGROUND
  The numbers of patients in acute care hospitals who require cardiac monitoring are increasing. Unpredictable fluctuations in patient flow may result in shortages of telemetry beds for patients who need this level of care.
  
  
  OBJECTIVE
  The aims of this study were to design and implement cardiac monitoring education for all medical-surgical nursing staff in a level I trauma center.
  
  
  METHODS
  This is a descriptive, quantitative performance improvement study. A multidisciplinary implementation plan was developed with biomedical engineering and physical facilities coordinating structural changes and nursing coordinating education and clinical competency. The nursing educational plans included a dysrhythmia course and testing, a clinically based competency, and a statistical analysis of the dysrhythmia test. The impact of this project was evaluated looking at areas transitioned, telemetry beds available, cardiac dysrhythmia education workshops, and dysrhythmia test results.
  
  
  RESULTS
  The implementation of cardiac monitoring was completed over 2 years. Monitored medical-surgical beds increased from 132 to 282 beds. The nursing education expanded hospital-wide to clinical areas requesting standardization of nursing practice.
  
  
  CONCLUSIONS
  In addition to expanding the number of monitored beds and decompression of critical care beds, benefits included increased level of staff competence, standardization of cardiac monitoring practices throughout the facility, and validation of the cardiac dysrhythmia test.
authors.affiliation: Janet T. Crimlisk, MS, RN, CNS, ANP-BC, is a clinical nurse educator at Boston Medical Center, Massachusetts. Ms Crimlisk has many years of experience in nursing as a clinical nurse specialist, nurse practitioner and nurse educator. Donald J. Johnstone, MBA, RN, is a clinical nurse educator at Boston Medical Center, Massachusetts. Mr Johnstone has worked in critical care and emergency nursing and is currently a medical surgical nurse educator. Michael R. Winter, MPH, is an associate director in Statistical Programming at the Data Coordinating Center, Boston University School of Public Health, Massachusetts. Mr Winter has over 25 years of experience in analyzing public health and clinical research data.
authors.forename: Janet T
authors.initials: JT
authors.lastname: Crimlisk
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Johnstone
authors.forename: Michael R
authors.initials: MR
authors.lastname: Winter
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000451:nursing; D001900:Boston; D002983:Clinical Competence; D004562:Electrocardiography; D006801:Humans; D007318:Inservice Training; D000069469:Medical-Surgical Nursing; D009741:Nursing Staff, Hospital / Q000193:education*; D015397:Program Evaluation; D014193:Trauma Centers