Reducing Overuse of Telemetry

Rachel Rotramel, MSN, CCRN, RN

Disclosures

Am Nurs Journal. 2021;16(7) 

In This Article

Strategies for Nurses

Continuous cardiac monitoring or telemetry is commonly used to detect lethal arrythmias in patients outside of critical care units. However, overusing telemetry can lead to nonactionable alarms, which distract from care and jeopardize patient safety. Some argue that telemetry offers a perception of safety that isn't evident in the literature. For example, according to Mohammad and colleagues, no outcome differences exist between patients with in-hospital cardiac arrest in non-critical care areas that were monitored on telemetry and those not on telemetry.

The American Heart Association (AHA) has developed evidence-based guidelines for appropriate telemetry use. The practice standards include a rating system that indicates three categories of patients and cardiac monitoring:

  • Class I: High indication for monitoring

  • Class II: May benefit, but not essential

  • Class III: No therapeutic benefit

Frontline nurses and nursing leaders can implement telemetry reduction strategies to improve value and quality of care. Primary interventions to decrease telemetry use include providing staff education, developing discontinuation criteria, integrating telemetry orders into daily communications, and hardwiring AHA standards into the organization's ordering practices.

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