Policy & Procedure for Telemetry

[Texas Transplant]

I need some help!! We are looking to expand our Telemetry units and are in the works of developing Policy and Procedure for this. Need suggestions and or ideas. I think these are unique to the facility. Just needing some to glean from. All help is appreceiated:typing

[RN1989]

What policies do you have in place now and what are you looking to improve/expand on?

[Texas Transplant]

This is what we have for

Patient Teaching

1.Reinforce the reason for telemetry.

2.To remain on the unnit except for testing or procedures.

3.To report any chest pain,dizziness, shortness of breath or if nitroglycerin taken. (This is not routinely kept at bedside).

4. To call nurse immediately if any chest pain.

Our guideline as of July 2006

1.Purpose:To assure monotoring alarms are set with appropriate settings and are suficiently audible with respect to distances and competing environmental soounds within the unit.

2.Policy

A.Alarms are in place to alert NS of changes in Pt condition and thus promote Pt safety by facilitating timely identification and communication of changes to the appropriate provider

B.Alarm setting are the responsibility of the profesional nurse assigned to the patient.

3.Procedure

A. The volume of alarms is not to be adjusted.If found to be inadequate,an electronic work order will be entered and accommodations will be made to provide for Pt safety.

B. Upon admission to the ICU or initiation of tele monitoring, the Pt will be monitored w/unit parameter settings. If Pt's clinical presentation is outside these parameters, the acepting Physician must be made aware of PT conditon,after which the alarms may be adjusted around the Pt's current readings to monitor for further changes. Parameter adjustments must be documented in the nurses shift note oft ICU Pt's or in the tele strip record for tele pt's. Any further adjustments to the alarm setting will be made only after the responsibllle Physician is notified of the changes in the Pt's reading. Further changes in alarm setting must also be documented.

C.Non-critical alarms may be disabled of the alert to an ongoing condition that is known to the Physician. Examples of this would be "irregular rhythm" for a Pt in atrial fibrillation, bijeminal or trijeminal PVCs. These changes would not require additional documentation.

D.Upon discharge or transfer of a Pt. teh monitor woll be reset ot the unit standard setting; this is the responsibility of the nurse discharging or transferring the pt.

E. The following alarms may not be disabled: Asystole(>4 seconds),V-fib,V-tach, Extreme Brady 250

REFERENCE JCAHO 2006 National Patient Safety Goal #6

REVIEWED BY: Nursing Executive Council

REVIEW DATE JULY 2008

Sorry this is so detailed but this is what we have so far and there have been situations where the Pt was taken off tele for bathing etc and also

the time limit for tele use ?48-72 hours.

Any and all feedback would be greatly appreceiated:typing

[RN1989]

Hey TX Transplant - bear with me. I think I still have some P&P but it has been packed away. Am looking through boxes and papers to find what I'm looking for to send you. Haven't forgotten you!

[Texas Transplant]

To RN1989, Thanks for the updated will keep "looking" for more info from :bowingpuryou. Again Thanks.

[RN1989]

I have found my P&P on this subject. I have policies from a couple of different places ranging from admit/dc criteria of pts to nursing/tele tech responsibilities. It is a lot of info to try and put into a field. If you have specific ideas I'll try and write them down. If you would like to pm me with a fax number I would be happy to fax you what I have found in my stash of papers.

[Texas Transplant]

To RN1989, thanks so much I've pm a fax number:yeah:

[Texas Transplant]

TO RN 1989

Received all faxes !!! There's alot there I can already tell we will be able to use.

[RN1989]

Great! I told my husband there was a use for carting so many boxes of papers all over the country all these years!

[Texas Transplant]

To RN 1989 YEah I know what you mean !!!! :chuckle

[ishbell]

Hi

I have recently taken over as the nurse manager on a 30 bedded cardiology ward with 30 telemetry monitors.

I am looking to set up guidelines re use of telemetry, as the practice on the ward has been to record every hour the rythm and rate of patients on telemetry, and I am questioning the rationale re this.

If anyone has any guidelines regarding the rationale in recording hourly obs I would be most grateful.

Also on a seperate note, I am looking to develop guidelines on the use of femstops and also a competency tool to assess staff competency in using femstops.

Any help most appreciated

Many Thanks

Ishbell:loveya:

[DLDoering]

I found your post about P&P for Tele. I am developing P&P for outpatient CV services. Do you have anything that you could share and/or have resources you can direct me to>