Education Methods

1. Initiation of Cardiac Monitoring on a Blood and Marrow Transplant Unit: An Educational Plan to Provide Continuity of Care for Patients Karen Harden MS, RN, AOCNS, Katy Gudritz MS, RN, Carol Kristofik, MBA, BSN, RN 7 West Blood and Marrow Transplant Unit, University of Michigan, Ann Arbor, MI Education Methods Purpose Results Implementation of cardiac monitoring on the Blood and Marrow Transplant (BMT) unit to provide continuity for patients and consistency in patient care. • Learning program requirements for all staff: • 3 day ECG class provided by hospital critical care orientation team • 1:1 and group learning sessions provided for staff as needed • Cardiac rhythm strip interpretation exam – Must pass with 80% success. • Bucket of practice strips for ongoing practice • Cardiac book and on-line practice strips • Reading EKGs for practice • 4 hour unit-based class • Review presentation of cardiac rhythms • Play “Cardiac Monitoring Jeopardy” • Hands-on sessions with cardiac monitor • Case Scenarios of cardiac arrhythmias in simulation lab with mannequin. • Hands-on demonstration of CIC (Central Information Center) • Care of patients on the cardiac monitor with every shift rhythm interpretation • Double checks of all cardiac strips by an experienced rapid response team member. Total of 70 nurses passed through our program Nurses are independently caring for patients with cardiac monitors. Zero patient transfers to telemetry units Continued support byRRT for rhythm interpretation Continued cardiac orientation program for new BMT nurses to educate about cardiac issues with BMT patients. Background Policy Development It was essential to develop a concise policy to guide our care and education as we progressed. We benchmarked other Blood and Marrow Transplant units in institutions around the nation to gather information on how cardiac monitoring was being used with transplant patients. We identified common arrhythmias and determined which cardiac agents would be acceptable. Our philosophy throughout the project was to start slow and build up to adding additional drugs once we considered the need of our patients and realized the increased skill of our nurses. Nurse Experience Although we have a team of highly experienced BMT nurses, the majority had no experience in managing cardiac monitoring and reading cardiac rhythm strips. We developed an extensive educational program for existing nurses and will continue to provide this education in the current orientation program. References Cardiac Monitoring Jeopardy Cleveland Clinic. (1995-2010). What is Atrial Fibrillation. Retrieved fhttp://my.clevelandclinic.org/heart/atrial_fibrillation/afib.aspx Bayer plx. (2008). Thrombosis Advisor. Retrieved from http://www.thrombosisadviser.co.uk/scripts/pages/en/current-treatments/current-approaches-to-antithromobotic-therapy/stroke-prevention-in-af/index.php Mayo Clinic. (2009-2010). Atrial Fibrillation. Retrieved from http://www.mayoclinic.org/atrial-fibrillation/symptoms.html National Heart Lung and Blood Institute diseases and condition index. (2010). Atrial Fibrillation. Retrieved from http://www.nhlbi.nih.gov/health/dci/Diseases/af/af_signs.html