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Title: Continuous ST-segment monitoring: nurses' attitudes, practices, and quality of patient care. Author: Sangkachand P, Sarosario B, Funk M. Journal: Am J Crit Care; 2011 May; 20(3):226-37; quiz 238. PubMed ID: 21532043. Abstract: BACKGROUND: Continuous ischemia monitoring helps identify patients with acute, but often silent, myocardial ischemia. Evidence suggests nurses do not activate ischemia monitoring because they think it is difficult to use. ST-Map software incorporates graphic displays to make monitoring of ongoing ischemia easier. OBJECTIVES: To determine if nurses' use of and attitude toward ischemia monitoring and the quality of patient care improve with use of ST-Map. METHODS: The study included 61 nurses and 202 patients with acute coronary syndrome in a cardiac intensive care unit. Baseline data on nurses' use of and attitude toward ischemia monitoring and quality of care were obtained. Education was then provided and ST-Map software was installed on all monitors. Follow-up data were obtained 4 months later. RESULTS: The percentage of nurses who had ever used ischemia monitoring was 13% before ST Map and 90% afterward (P < .001). The most common reason for not using ischemia monitoring before ST Map was inadequate knowledge (62%). The most common reason for liking ischemia monitoring after ST Map was knowing when a patient has ischemia (80%). Time to acquisition of a 12-lead electrocardiogram in response to symptoms or ST-segment changes was 5 to 15 minutes before ST Map and always less than 5 minutes afterward (P < .001). Time to return to the catheterization laboratory did not differ before and after ST Map. CONCLUSIONS: ST Map was associated with more frequent use of ischemia monitoring, improved attitudes of nurses toward ischemia monitoring, and shorter time to obtaining 12-lead electrocardiograms.[Abstract] [Full Text] [Related] [New Search]