Patents experiences of in-hospital telemetry monitoring

Abstract

Abstract Background Telemetry monitoring is a cornerstone of care in in-hospital arrhythmia monitoring. Annually, a large number of patients experience arrhythmias that need to be monitored and treated during hospital stay. However, studies focusing on patients' experiences of telemetry monitoring are scarce. Purpose To explore and describe adult patients' experiences of in-hospital monitoring in a non-intensive care unit setting. Methods In-depth interviews with an inductive, explorative and descriptive design were performed before hospital discharge at two university hospitals in Norway. Twenty patients were purposefully selected. Inclusion criteria were; monitored for more than 72 hours, with at least one serious arrhythmia registered. A qualitative content analysis according to Graneheim and Lundman was performed revealing categories at a manifest level. Findings Patients were 25–83 years (mean 62), and had spent an average of 9 days on telemetry (3–14). Patients were monitored due to primary arrhythmia (9), STEMI (2), syncope (2), TAVI (1), acute heart failure (1), heart transplant (1), GUCH (1) and non-cardiac causes (3). Four main categories were revealed from the analysis. Firstly, patients' experienced to receive limited information related to the purpose and results of the monitoring. Communication with the staff and immediate response to arrhythmias were important factors to feel safe and taken care of during hospital stay. Secondly, patients experienced the monitoring system to be troublesome. The device and the wires attached made it challenging to maintain adequate hygiene. Patients also experienced sleeping problems related to both wires and disturbing alarms, and described pain in the neck due to the weight of the telemetry unit. Thirdly, patients' experienced a restricted range of activity. Patients experienced the restricted radius of movement as a feeling of security, even though patients also described uncomfortable feelings like “wearing an ankle brace”. Fourthly, patients' experienced uncertainty at hospital discharge as the telemetry monitoring was discontinued, especially if they still experienced arrhythmias. Conclusion The information provided to patients on telemetry monitoring is poor and there is need for a better system to carry the telemetry in order to ease mobilisation and facilitate good sleep. Patients need to be informed about the results of the telemetry monitoring, to help them to be familiar with their arrhytmia, and increase the experience of security after discharge. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): 1 Department of Health and Social Sciences at Western Norway University of Applied Sciences, Norway2 Department of Heart Disease, Haukeland University Hospital, Norway