Off-site cardiac rhythm monitoring can detect problems in non-critically ill patients an hour earlier than in-house emergency response, according to a new study from the Cleveland Clinic.
The system allowed the organization to reduce the number of patients under continuous monitoring, and there was no increase in cardiopulmonary arrest events, according to the study, published in the Journal of the American Medical Association.
Alarm fatigue and other distractions at the nurses’ station can divert attention from patient monitoring, the authors note. The organization set up a separate facility off-site to monitor non-ICU patients at the Cleveland Clinic and three regional hospitals over 13 months, according to an announcement.
Early on, standardized cardiac telemetry was associated with a mean 15.5 percent weekly reduction in the number of patients monitored despite no overall drop in hospital census. Lead technicians provided onsite oversight and supervision for the nursing staff. Patient monitoring was considered a shared responsibility between the central monitoring unit (CMU) and nursing, with both sides accountable in the process. The hospital employs an emergency response team (ERT) that the CMU notified directly of critical events.
The CMU received electronic telemetry orders for 99,048 patients and provided 410,534 notifications.
The CMU correctly notified the ERT in 79 percent of critical events (772 cases) and drew attention to the worsening condition of 105 patients. It provided early alerts to 27 cardiopulmonary arrest events; 25 of those patients survived.
In the 13 months prior to setting up the CMU, the organization logged 126 cardiopulmonary arrests; there were 122 in the post-intervention period.