Frequency of running/documenting telemetry strips

[BennyRsMom]

I work in a 10-bed ICU. As a relatively new ICU nurse I absolutely love this forum. I have learned so much (and also learned how much I don't know). Most of my colleagues have worked on the unit for a long time and are naturally not as knowledge-hungry as I am. We are responsible for telemetry monitoring and posting a telemetry strip in our pts. chart every 4 hours. With each hourly set of vital signs we also document the rhythm. Should an interpretation of the rhythm with measurements of the P-R, and QRS also be written on the strip. What is the standard policy?

[stressgal, RN]

My facility requires q4 hour running of monitor strips. I do document the intervals as this is the best way for me be aware of changes. Of course if there is any significant changes noted or bothersome ectopy I will print up a strip, mount and document the abnormal rhythms in addition to my scheduled 4 hour strips. Best advice is look at your facility's policy and at the minimum follow it.

[MiCountry]

We document q6h but I have been checking this closer. When we print a strip directly from the monitor the st is documented in the text area. Wheb we print it from the history the st is not documented. Have you noticed this w your posted strips?

[Patchouli]

strips are printed q 6 hrs here, and the pr, qrs, and qt are all documented with the strip along with the rhythm.

[ICUnurse1997, MSN, APRN]

We recently encountered an issue in our unit regarding measuring and interpreting monitor strips. Our policy is to print strips every 4 hours and measure intervals and write an interpretation of the rhythm. I had a patient with an inferior MI who had an AV disassociated rhythm. Two nurses before me did not recognize this rhythm because they were just printing off strips and putting them on the chart without doing measurements. When I brought up this issue with this example at our last unit meeting, I was immediately overridden by a couple of staff members who did not feel comfortable writing an interpretation of the rhythm. My issue was more with not doing measurements where I feel the AV disassociation would have been detected. At least my manager stood up for me and said it was our policy and she would be monitoring compliance. Also, we usually just measure PR, QRS intervals. I have been trying to encourage routine measurement of QT intervals as well. I am interested to know if anyone has a policy on continuous ST segment monitoring.

[meandragonbrett]

We post strips of EKG (2 leads), CVP, A-line, PA, and ICP/EVD waveforms at beginning of shift and with any changes (changes in rhythm, or if the PA is repositioned, etc.). We have some that measure and some that do not.

[CNL2B]

We are required to run a tele strip in two leads (usually we use II, V1) every shift (8 hours, so 3 times/day) and write a complete interpretation including intervals and rhythm. Our invasive monitoring strips are the same (IABP, CVP, PA). This varies from facility to facility though and all ICUs should have a policy on what their routine for posting strips is.

[lkwashington]

We recently encountered an issue in our unit regarding measuring and interpreting monitor strips. Our policy is to print strips every 4 hours and measure intervals and write an interpretation of the rhythm. I had a patient with an inferior MI who had an AV disassociated rhythm. Two nurses before me did not recognize this rhythm because they were just printing off strips and putting them on the chart without doing measurements. When I brought up this issue with this example at our last unit meeting, I was immediately overridden by a couple of staff members who did not feel comfortable writing an interpretation of the rhythm. My issue was more with not doing measurements where I feel the AV disassociation would have been detected. At least my manager stood up for me and said it was our policy and she would be monitoring compliance. Also, we usually just measure PR, QRS intervals. I have been trying to encourage routine measurement of QT intervals as well. I am interested to know if anyone has a policy on continuous ST segment monitoring.

Do you all have monitor tech watching the monitors? If so, it should have been caught by them. Yeah sometimes we catch things before the tech but it went through two nurses. Just a thought.

[ICUnurse1997, MSN, APRN]

We don't have techs watching our monitors in the ICU. The nurses are responsible for watching and interpreting the rhythms. The medical and surgical floors have remote monitor techs watching their monitors.