504-U9-a-A: Clinical Practical Guideline for Telemetry

Clinical Practical Guideline for Telemetry
Name
Institution
Clinical Practice Guideline for Telemetry
Introduction – Overview of Clinical Practice Guideline
The guideline was developed to help monitor telemetry. It outlines ways of assessing telemetry and details how to help adult patients on cardiac or surgical/medical step-down units at “Winnipeg Regional Health Authority” (WRHA)
The document has a nursing potion that provides guideline on ways of communicating and documenting information for adult patients that need telemetry. The main goal of the guideline is to aid in decision-making on how to make optimum use of “telemetry resources”. As a result, the aim of the guideline is to be used together with individual clinical decisions relating to patient management and care.
The guiding principles for the guideline include: “WRHA acute care facilities” come up with the necessary telemetry monitoring policies/procedures that does not violate the “regional guideline”, authorized physicians “at each WRHA acute care facility” give the greenlight to go ahead with telemetry within the chosen telemetry services, and there is a 24 hour assessment of the need for telemetry services.
The guideline identifies ICU/tertiary community as medical/cardiac patients in ICU/CCU who need to be continuously monitored for cardiac, prepared to mobilize, can be telemetry monitored and be accepted to go to the wards. Cardiology and “medical -surgical inpatient units are regarded as those patients who never meet the criteria for “coronary care” and therefore do not need to be transferred to the intensive care unit but still need telemetry. Those patients who do not need telemetry are regarded to have “low risk acute coronary syndromes”.
The guideline goes further to outline methods of lead selection, how to document vital signs, measuring cardiac rhythm, ST monitoring, maintaining safety, communication, patient education, staff education (for nurses responsible for monitoring and remote telemetry), and maintaining quality. Following the guideline is in the hope that it will be useful in detecting life threatening and serious variations in the cardiac rhythm of a patient so that early “therapeutic intervention(s)” can be carried out.
How Different Professionals are Held to the Guide
The first main duty of healthcare professionals is to determine the category of a patient. In this regard, it would be their duty to tell if a patient needs to be in ICU, whether they need to be in “medical-surgical in patient units”, or whether they do not need telemetry. The healthcare professionals would have to document the “vital” signs (blood pressure, O2 sat, RR, and pulse). Healthcare professionals are also expected to measure the cardiac rhythm of patients and analyze them (Najafi & Auerbach, 2012). Any abnormalities are reported to the health care provider in charge.
The guideline also requires the healthcare professionals to perform ST monitoring to determine if there are any “acute coronary syndromes”. Most importantly, the guideline provides them with ways of ensuring safety, effectively monitoring alarms and determining the quality of cardiac monitoring. If not, the guideline provides them with effective ways of ensuring that the required quality is achieved. It is also the role of the healthcare providers to ensure that there is efficient and timely communication on initiation and discontinuation of telemetry, changes on “cardiac rhythm” (Cleverley et al., 2013).
Another key duty for healthcare professionals outlined in the guideline is on how to ensure patient education. It is their duty to ensure patients get “telemetry education sheet” and reminding them to ensure that they never hesitate to call for the help of a nurse if they feel their clinical condition has registered any changes. The guideline also calls for healthcare professionals to ensure that any staff mandated to monitor telemetry must be adequately trained. The goal is to ensure that each of these staff understands the guidelines for regional telemetry. Finally, healthcare professionals have a duty to ensure quality; therefore, they must review unit protocols periodically; and ensure that staff is continuously trained to maintain and improve their competence level. The goal is to ensure that both the needs of the staff and the patients are met at all times. Therefore, healthcare professionals must periodically review critical events, patient outcomes, and staff performance.
Research Reference
The research that might have been used to adopt the guideline as “Promoting Adoption of Clinical Practice Guidelines”. The article argues that promoting the use of guidelines presents a major hurdle for different health institutions. Researchers have focused on presenting the guidelines as easy to use, and effective in order to encourage more people to embrace them. The major attribute expected of the guidelines is that they should be specific and clear to the intended users for them to be easily adopted (Graham et al., 2011). The guideline was precise and to the point.
The rate of adoption of the guidelines is determined by their nature such as type, complexity, and strength embodied in their evidence, relevance to practice and perceived evidence (Graham et al., 2011). It is normally easy to adopt guidelines for simple healthcare practices compared to the complex ones. Whenever coming up with a guideline, attention must be paid to the organization of its contents and how key messages are laid out.
Guidelines must be well communicated to promote their adoption. The most common communication strategies include: mass media and education, opinion leaders, and academic detailing (Graham et al., 2011). Challenges will be encountered whenever trying to implement these guidelines. These challenges include: systems and data challenges, generalizability challenges, and certain legal issues. With the growth of health information technology systems, many health practitioners have grown of the opinion that guidelines need to be compatible electronically for them to positively influence their future practice. The challenge of generalization arises because there has never been codification and standardization of guidelines to come up with one adoption applicable to all healthcare settings.
Instances of malpractices in the health care setting are still an unsolved issue. Guidelines can be engulfed by disputes and liability suits over what insurance policies do or should cover and ways in which to interpret medical necessity. Medical malpractices affect healthcare providers in one way or another whether they have been sued or not.
Evidence Used to Define the Guideline
The evidenced based practice (BEP) used to define the guideline was systematic evidence based review. The developers of the guideline did review a lot of past work on telemetry. According to Hall & Roussel (2016), systematic reviews help in identification, appraisal and synthesis of all the “empirical evidence” that provide an adequate answer to a given research question. When using systematic review, the main goal of researchers is to ensure that biasness is as low as possible s...