By Editor: Suzanne M. Burns
AACN Protocols for perform: Noninvasive tracking delineates the facts for utilizing units for noninvasive sufferer tracking of blood strain, middle rhythms, pulse oximetry, end-tidal carbon dioxide, and respiration waveforms. those protocols consultant clinicians within the applicable collection of sufferers to be used of the gadget, program of the machine, preliminary and ongoing tracking, machine elimination, and chosen points of quality controls.
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Additional resources for AACN Protocols for Practice: Noninvasive Monitoring, Second Edition
Nursing education needs to include (1) the goals of monitoring for individual patients (ECG abnormalities and arrhythmias essential to detect based on the patient’s clinical problem); (2) diagnostic criteria for recognizing arrhythmias and ECG abnormalities; (3) most valuable leads for bedside monitoring and proper placement of electrodes and attachment of lead wires to obtain these leads; and (4) strategies to promote better detection, documentation, and diagnosis of arrhythmias. Comparison Studied A questionnaire was used to ask nurses to demonstrate placement of electrodes and attachment of lead wires for 25 8.
A larger sample size would be helpful, especially with wide QRS beats that differ between leads V1 and MCL1. Clinical Implications Using lead MCL1 or lead MCL6 is recommended for monitoring for arrhythmias when lead V1 or lead V6 cannot be used, as is the case with a 3-wire system. Use of established criteria for differentiating the origin of wide QRS complex beats is helpful so long as these beats are recorded in leads MCL1, MCL6, V1, or V6, and preferably in both V1 and V6 or both MCL1 and MCL6.
Ninety-one percent demonstrated incorrect technique for obtaining lead MCL1, and 88% demonstrated incorrect technique for obtaining lead MCL6. Additional findings of this study showed that nursing routines and practices do not promote appropriate selection of leads, documentation of arrhythmia, or accurate placement of leads. Study Strengths and Weaknesses A major strength of the study is that it targeted bedside monitoring practices and showed areas of weakness in a majority of nurses’ practice in this area.