Improving Nurses’ Corrected QT Interval Monitoring on a Telemetry Unit
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2023
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University of Hawaii at Manoa
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Abstract
Importance: Corrected QT interval (QTc) prolongation was a type of ventricular tachyarrhythmia that could result in torsades de pointes (TdP) and sudden cardiac death. Recommendations and ongoing education for QTc interval monitoring and TdP for telemetry nurses were limited and variable. Improvement of nurses’ QTc interval monitoring allowed an opportunity to initiate escalation of care in a timelier manner, improve the prevention of TdP and ultimately improve the overall mortality rate in a hospital setting. Methods: An evidence-based QTc interval monitoring and TdP educational presentation was developed according to current guidelines and practice standards for electrocardiogram monitoring, with input from experts. The nursing staff on the study telemetry unit received education on QTc interval monitoring and TdP. A knowledge and self-efficacy assessment was administered to nurses at baseline and immediately after the educational intervention. Results: Participants’ knowledge improved after the educational intervention, with an overall average of 68.58% correct responses to knowledge assessment questions at baseline and 80.42% immediately after education. Similarly, participants’ self-efficacy improved after the educational intervention, with an overall average score of 18.27 on a 30-point scale at baseline and 23.47 on a 30-point scale immediately after the intervention. Discussion: This evidence-based QT educational presentation based on American Heart Association practice standards for QTc interval monitoring improved nurses’ knowledge and self-efficacy with QTc interval monitoring and TdP. Project findings demonstrated that relying solely on education was insufficient, suggesting that a comprehensive approach would aim to enhance and ensure the integration of evidence-based practice standards into daily clinical practice.
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Heart rate monitoring, Long QT syndrome, Nurses--In-service training
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