Evaluation of appropriateness and outcome of in-hospital telemetry monitoring

The telemetry technology has during the last four decades been used for in-hospital detection of arrhythmias, in a diversity of medical and surgical patients. This is still a cornerstone of care in most critical care settings.

Telemetry monitoring decreases the need for beds in intensive care units and is now widely used in non-critical care wards. The American Heart Association (AHA) classifies monitored patients into three categories. The aims of this study are to (i) investigate how patients are assigned according to the AHA classification and (ii) describe number and type of arrhythmic events and subsequent change in management.  iii) examine whether the time frame of monitoring is appropriate and (iv) to determine length of stay (LOS) on telemetry. 

A prospective observational study design was applied. All patients assigned to telemetry at one university hospital during a three month period were consecutively enrolled. Data were collected 24/7. Only arrhythmias that might require change in management were recorded. A standard data sheet with sixty-four variables was completed by monitor watchers at the central monitor station and reviewed by the investigator. Medical records were reviewed in all patients (1).

Two sub-studies focusing on correct electrode placement, hygiene and patient information were subsequently performed (2,3). Practice standards on in-hospital telemetry monitoring at Haukeland University Hospital was prepared in 2014 (4).

1. Fålun N, Nordrehaug JE, Hoff PI, Langørgen J, Moons P, Norekvål TM. 2012. Evaluation of appropriateness and outcomes of in-hospital telemetry monitoring.  Am J Cardiol. 2013 Oct 15;112(8):1219-23.

2. Pettersen TR, Fålun N, Norekvål TM. Improvement of in-hospital telemetry monitoring in coronary care units: An intervention study for achieving optimal electrode placement and attachment, hygiene and delivery of critical information to patients. Eur J Cardiovasc Nurs. 2014 Dec;13(6):515-23.

3. Sæthre I, Ludvigsen T, Fålun N, Norekvål TM. Kartlegging av elektrodeplassering, hygiene og pasientinformasjon ved telemetriovervåking av hjertepasienter - en pilotstudie (Telemetry monitoring of cardiac patients. A survey of electrode placement, hygiene and patient information). Vård i Norden. 4/2012. Vol 332, nr. 1, p 47-52.

4. Fålun N, Hoff PI, Norekvål TM, Langørgen J.  Retningslinjer for bruk av telemetri ved Haukeland Universitetssjukehus (Practice standards on in-hospital telemetry monitoring at Haukeland University Hospital). Hjerteforum 2014;4:33-36.