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Does this patient need telemetry? An analysis of telemetry ordering practices at an academic medical center
Author(s) -
Chen Stephanie,
Palchaudhuri Sonali,
Johnson Amber,
Trost Jeff,
Ponor Ileana,
Zakaria Sammy
Publication year - 2017
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12708
Subject(s) - telemetry , medicine , emergency medicine , medical emergency , guideline , acute coronary syndrome , cardiology , pathology , myocardial infarction , engineering , aerospace engineering
The American Heart Association and Choosing Wisely campaign recommend guideline‐based usage of telemetry. Inappropriate use leads to increased costs, alarm fatigue, and inefficient nursing care. This study assesses provider ordering practices for telemetry at a US‐based academic hospital. Methods This retrospective study includes all telemetry orders in the medicine and progressive care units from April 2014 to March 2015. Indications were grouped into categories per American Heart Association guidelines. Results The top 3 cardiac indications included angina/acute coronary syndrome (35.3%), arrhythmias (19.7%), and heart failure (10.2%). However, noncardiac indications accounted for 20.2% of orders, including respiratory conditions (17.4%), infection (17.4%), substance abuse (14.0%), bleeding (12.4%), vital sign monitoring (10.4%), altered mental status (7.0%), and pulmonary embolus/deep vein thrombosis (7.0%). Conclusions One‐fifth of patients were monitored on telemetry for noncardiac indications. We recommend further study on the benefits and risks of telemetry in these patients and systems‐based changes for appropriate usage.