Abstract 2097: National Survey of Cardiologists’ Perceptions of Continuous ST-segment Monitoring

Abstract

Continuous ST-segment (cST-seg) monitoring has been shown to help identify early and transient cardiac ischemia. American Heart Association and American Association of Critical Care Nurses recommend its use among specific patient populations. Investigators examined factors associated with cardiologists’ reported benefits, barriers, and perceptions of usefulness for cST-seg monitoring. A random sample (n=200) within a national pool of 4,985 cardiologists registered with the vendor Epocrates® was electronically surveyed. Cardiologists agreed/ strongly agreed that benefits of cST-seg monitoring included early identification of potential ischemia (83.5%), and early identification of reocclusion after PCI (74%) or fibrinolytics (72.5%). Cardiologists agreed/strongly agreed that barriers included false positive alarm for ischemia (61.5%); lack of understanding of this technology by nursing staff (56.5%); extra phone calls based on inaccurate monitoring (48%); lack of understanding of this technology by other physicians (47%); and extra cost/ treatment due to false positive alarms (43%). Cardiologists agreed/strongly agreed that cST-seg monitoring identifies patients who need further tests (69%) and is clinically useful in detecting transient myocardial ischemia (65%). The primary factor associated with higher benefits, clinical usefulness, and past use of cST-seg monitoring by cardiologists was whether or not their hospitals had a standard of practice for using cST-seg monitoring. The secondary factor was awareness of published consensus guidelines for cST-seg monitoring. Findings may indicate that when cardiologists are given the opportunity to work with a hospital that provides guidelines and experience in cST-seg monitoring, they may be more likely to appreciate its benefits and clinical utility. Clinical leaders should initiate multi-disciplinary efforts to review the level of evidence for possible incorporation of cST-seg monitoring into their hospitals’ standards of practice. Findings will help direct further research and interdisciplinary education in appropriate use of technology by critical care nurses and cardiologists.