1 / 19

Safe Monitoring Practices using GE Monitoring Systems

Safe Monitoring Practices using GE Monitoring Systems Central Information Center (CIC) and Apex Pro Telemetry,. Ruth Zafian MSN, MA, ACNS-BC, APRN Clinical Nurse Specialist Cardiovascular Services. Objectives: By the end of the program the participants will be able to:

kyla-stanley
Download Presentation

Safe Monitoring Practices using GE Monitoring Systems

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Safe Monitoring Practices using GE Monitoring Systems Central Information Center (CIC) and Apex Pro Telemetry,. Ruth Zafian MSN, MA, ACNS-BC, APRN Clinical Nurse Specialist Cardiovascular Services

  2. Objectives: By the end of the program the participants will be able to: 1) Describe the phenomenon of desensitization to monitor alarms (Alarm Fatigue) and the measures members of the healthcare team can take to prevent it’s occurrence. 2) Navigate screens in the GE CIC to perform common functions associated with telemetry and hardwire physiologic monitoring of patients. 3) Demonstrate proper use of the GE Apex-pro telemetry system. 4) Discuss and differentiate the roles of the RN, PCA and PAA to ensure patient safety and quality of care in relation to physiologic monitoring. 5) List key elements of the HH Guideline for Cardiac Monitoring and describe how this will be incorporated into their practice.

  3. Handouts: • Diagrams of Pacemaker Electrode Placement • RN CIC Skill checklist • A sample of a printed page from the history review where the GE caliphers were used. Note the stickers that were applied. • A rhythm strip • The ECG Rhythm log form

  4. Alarm Fatigue can be Lethal It seems so simple; but it’s not! • It happened at John Hopkins; • It happened at Massachusetts General; • and Yes, it’s happened here.

  5. Too much noise; too many alarms, I don’t Know When my patient is really…

  6. In trouble…

  7. It’s not just a heart rhythm that you’re watching… it’s a personwho’s relying on you to save their life if they have a fatal arrhythmia.

  8. So let’s get this right and eliminate Nuisance alarms. - Skin prep. - Fresh electrodes, placed properly. - Change electrodes every 5 days and PRN - Respond promptly to all alarms including “Leads off”. - Customize alarms as outlined in the “Guideline for Cardiac Monitoring”. - The RN is responsible to ensure the reason that the alarm happened is addressed.

  9. GE CIC Alarms – Learn the levels Patient Status Alarms: Crisis alarms – Life Threatening (V-tach, Asystole) Warning alarms – Serious (Tachy, Brady, Low SP02) Advisory alarms – (PVC couplets) Message – (A-fib) System Status Alarms: Warning – (Lead off, Low Battery) Advisory – No Comm Message - Warning! Warning! Warning!

  10. Patient Status Alarms

  11. System Status Alarms Foghorn sounds – either repeating or a single sound For Warnings – Lead Off or low Battery Do Not Blow this Alarm Off Fix it quickly! Your patient’s rhythm might not be displayed or may disappear soon…. Then what? It’s like they’re not on the monitor at all! Your patient might be asystolic.

  12. Silence is Golden, …. But…. Fraught with Danger! What to do with the NO COMM message

  13. Alarm Pause • Click Monitor Setup, then Alarm Control • Click Alarm Pause-Smart Alarm • Click down arrow to display a list of reasons • Select the reason for pausing the alarm • The reason will be displayed in the patient’s window

  14. Customize your alarms Please see the full guideline you received when you started the Arrhythmia Interpretation course.

  15. Do you understand the implications of the Guideline for Cardiac Monitoring? • How often to document rhythm strips? • That the RN MUST sign the rhythms strips? • That someone must always be near enough to the CIC to see and hear alarms? • How often alarm history reviews must be performed? • That alarm settings must be documented (at default or otherwise)? • That alarm settings can be changed by an RN within limits – see chart on the last page of the guideline? • The RN needs to document that he/she made/authorized the alarm change(s)? • When to use the relearn button? • When the PAA needs to notify the RN? • Monitored Pts need an RN, PA, APRN, MD to travel with them?

  16. What can you do to minimize nuisance alarms and alarm fatigue? • Prep skin well before applying electrodes. • Do not place electrodes over large muscles. • Change electrodes q 5 days and PRN. • Pick the “best” lead to monitor. • Use ECG settings to get the best tracing. • Customize alarm settings. • Respond to and correct all alarms ASAP. • Use “Alarm Pause” when your patient is off the monitor or unit. • Use the “Relearn” button often. • Do NOT ignore “leads off” alarms. • Seek orders to discontinue the monitor when the patient no longer needs monitoring

  17. Great Cardiac Monitoring required all • of us to use critical thinking skills.

  18. The buck stops here! Protect your patient

  19. Let’s practice…

More Related