title: Proper skin preparation and electrode placement decreases alarms on a telemetry unit.
abstract: BACKGROUND
  An estimated 85% to 99% of electrocardiographic (ECG) alarms are false, leading to alarm fatigue, which is associated with increased risk of death among hospitalized patients.
  
  
  OBJECTIVE
  The aim of this study was to examine the effect of proper skin preparation and electrode placement on frequency of ECG alarms on a telemetry unit.
  
  
  METHODS
  A prospective descriptive design was used to test the effect of proper skin preparation and ECG electrode placement. Purposive sampling of patients (n = 15) admitted to a telemetry hospital in a suburban Veterans Affairs Medical Center was used. Alarms were counted for 24 hours after admission, electrodes were replaced using proper technique, and alarms were counted for 24 hours after electrode change. Bootstrapping was used to double the sample size for analysis.
  
  
  RESULTS
  Electrocardiographic alarms decreased significantly (P < .05) after proper skin preparation and electrode placement (95% confidence interval, 1.273-82.327).
  
  
  CONCLUSIONS
  Proper skin preparation and ECG electrode placement reduced alarms. Reducing alarm frequency is vital to decreasing alarm fatigue and increasing patient safety.
authors.affiliation: Colleen Walsh-Irwin, DNP, RN, ANP, CCRN, is the cardiovascular clinical nurse advisor for the Department of Veterans Affairs, Northport, New York. She is a clinical assistant professor at Stony Brook University School of Nursing. Dr Walsh-Irwin has an extensive cardiac nursing background and currently works as a cardiology nurse practitioner. Corrine Y. Jurgens, PhD, RN, ANP-BC, FAHA, FAAN, is a tenured associate professor and director of Cardiovascular Nursing Research in the School of Nursing at Stony Brook University. Her research has been supported by the American Heart Association (AHA), the Hartford Foundation and Stony Brook University School of Nursing. She was inducted as a fellow of the American Academy of Nursing in 2014. Dr Jurgens is an active member of the AHA and Heart Failure Society of America (HFSA). She is a fellow of both the AHA Cardiovascular Nursing Council and the Quality of Care and Outcomes Research Council. Dr Jurgens also sits on the HFSA executive council. She reviews for several research journals and is on the editorial board for the Journal of Cardiovascular Nursing. Dr Jurgens has a clinical background in critical care and cardiovascular nursing.
authors.forename: Colleen
authors.initials: C
authors.lastname: Walsh-Irwin
authors.forename: Corrine Y
authors.initials: CY
authors.lastname: Jurgens
mesh_terms: D000368:Aged; D000071064:Alert Fatigue, Health Personnel / Q000517:prevention & control; D056902:Clinical Alarms; D004562:Electrocardiography; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D009518:New York; D061214:Patient Safety; D011446:Prospective Studies; D017592:Skin Care; D013686:Telemetry