Telemetry Practices Among Physicians and Nurses at an Academic Tertiary Medical Center

Abstract

Background: Cardiac telemetry is an integral part of inpatient medicine, although it is also costly, labor-intensive, and a limited resource. In this quality improvement initiative, we surveyed nurses, residents, and attending physicians regarding their knowledge and application of the American Heart Association (AHA) guidelines for telemetry usage. Methods: Our study included developing and implementing a survey among nurses, residents, and attendings in a major academic teaching hospital. Participants’ application of the AHA guidelines was also evaluated using a 7-question sample of hypothetical patient scenarios. A total of 73 physicians and 64 nurses were surveyed. Results were analyzed using chi-square test analysis, and a p-value of ≤0.05 was considered statistically significant. Results: Physicians reported being more comfortable than nurses in discontinuing telemetry (p<0.001) although nurses reported being more comfortable with the AHA guidelines compared to physicians (p<0.001). 81% of physicians somewhat or strongly agreed that cardiac telemetry was overused versus 48% of nurses (p<0.001). Attending physicians were more comfortable than resident physicians with the AHA guidelines, discontinuing telemetry, and daily review of telemetry orders. In four out of seven hypothetical scenarios, nurses reported being more likely to use telemetry compared to physicians when telemetry was not indicated. Conclusion: There is a notable difference in knowledge and attitudes toward utilization and indications of cardiac telemetry among nurses, resident and attending physicians. An educational program is warranted detailing the AHA cardiac telemetry guidelines and their clinical application.