telemetry monitoring ratio

EricJRN, MSN, RN · May 23, 2007

I moved your thread from Nursing News to the Cardiac Nursing Forum for more responses. Good luck to you!

jmgrn65, RN · May 23, 2007

don't know never thought of it. probably not. These days the monitors will alarm for just about everything, you need someone there to look when the alarms go off and respond appropriately.

anonymurse · May 23, 2007

It's not the numbers by themselves that would bother me, it's loss of the tech's patient familiarity (knowing what constitutes a significant event for each patient) and physical accessibility (RN being able to interact with the tech face to face). Also, we get to know each tech's experience level, critical thinking abilities and general level of vigilance (as well as being able to size up whether they're tired or distracted that day if they're sitting at the nurses' station). Then we can adjust our own monitor watching to suit. Plus I think it makes for better quality of care for the tech to be able to grab a nurse flying by the station and hand them a fresh battery for this patient or ask them to check the leads on that patient. Nurses are more compliant with in-person requests made by another member of the unit.

pickledpepperRN · May 23, 2007

It's not the numbers by themselves that would bother me, it's loss of the tech's patient familiarity (knowing what constitutes a significant event for each patient) and physical accessibility (RN being able to interact with the tech face to face). Also, we get to know each tech's experience level, critical thinking abilities and general level of vigilance (as well as being able to size up whether they're tired or distracted that day if they're sitting at the nurses' station). Then we can adjust our own monitor watching to suit. Plus I think it makes for better quality of care for the tech to be able to grab a nurse flying by the station and hand them a fresh battery for this patient or ask them to check the leads on that patient. Nurses are more compliant with in-person requests made by another member of the unit.

I agree. It is not safe for the tech to be on another unit.

All_Smiles_RN · May 23, 2007

I doubt there are any law governing as I've heard of units that have monitors at the nurses station and no monitor tech. I suppose the nurses just keep an eye on the monitors when they are at the station??

I work on a 24 bed unit and until a few months ago, we had our own monitor tech. now our monitor tech has to monitor two other floors where pts are ordered remote tele... about 60 pts now. one of the biggest issues our monitor techs tell us about is the slow response they get when requesting new batteries or adjustment of leads on other floors. sometimes a pt will be off the monitor for an hour! they have had to call the nursing sup to get involved at times! our monitor techs have been quitting because of the added stress... its all about the bottom line...

pickledpepperRN · May 23, 2007

It is unsafe. A sentinel even can be prevented by having a tech on each monitored unit.

vamedic4, EMT-P · May 24, 2007

OMG I think I'd blow something up if I were responsible for watching up to 60 pts on tele during a shift. As Anonymurse said...that's an awful lot of things to be responsible for, given that each patient has his/her own "norms" in terms of their ectopy. I watch up to 22 peds cards pts. and it's a helluva chore sometimes just keeping up with them...esp. if they're acting up!!

I have no idea if such laws exist, but check with your organization and the state - they may have some ideas for you. What you describe is nothing short of dangerous.

And I agree...if you're monitoring the tele, you need to be ON the floor where the pts. are...not in some isolated closet somewhere down in the bowels of the hospital. You need to be able to let people know immediately exactly what you see so they can appropriately respond.

Ouch...that's wayyyy too many patients.

vamedic4

meandragonbrett · May 30, 2007

We have a remote monitoring room for the entire hospital (every bed is tele capable). There is an alarm system that will alert us to various issues with the tele. Monitor Techs also page overhead on the unit "Nurse to Room 4401 STAT" for instances such as vtach, vfib, asystole, etc. They also call the floor anything the rhythm changes and speak with said patient's nurse.

pickledpepperRN · Jun 15, 2007

We have a remote monitoring room for the entire hospital (every bed is tele capable). There is an alarm system that will alert us to various issues with the tele. Monitor Techs also page overhead on the unit "Nurse to Room 4401 STAT" for instances such as vtach, vfib, asystole, etc. They also call the floor anything the rhythm changes and speak with said patient's nurse.

How does the RN responsible for the patient observe the rhythm?

meandragonbrett · Jun 15, 2007

We have a monitor at the desk that we can view all pts on tele and print off strips if needed.

The monitor techs are the ones that are actually monitoring rhythms 24/7. They have an rhythm course taught by the ICU staff and must pass the final exam with 100%. Anytime a rhythm changes or a significant rate change occurs, (i.e. normal sinus converts to sinus tach) the particular tech calls the floor and speaks with that pts RN to notify of the rhythm change.

They also fax a rhythm report q8h to let the staff know of the trends of that patient.

pickledpepperRN · Jun 15, 2007

Thank you.