Background: Patients at high risk for cardiac events often receive telemetry, however, overutilization of cardiac monitoring leads to unnecessary interventions and increased healthcare costs. The American Heart Association (AHA) recommends classification of cardiac risk via symptoms and clinical course for determining telemetry needs as Class I, II, or III from highest to lowest risk respectively. [...]

Background: Advancements in technology have expanded accessibility to telemetry via remote monitoring and resulted in increased application in hospitalized patients. The American Heart Association (AHA) telemetry guidelines restrict use to patients with sepsis, severe electrolyte disturbances or primary cardiac conditions. Respiratory infections have emerged as a common source of hospitalization and telemetry is frequently applied [...]

Background: Telemetry is an essential tool for real-time monitoring of the heart rhythm and QRS morphology of a patient. American College of Cardiology and American Heart Association had published their respective practice standards for in-hospital cardiac monitoring for the detection of cardiac arrhythmias. Nonetheless, these recommendations were mostly based on expert opinions which focused almost [...]

Background: Delays in treatment of in-hospital cardiac arrest (IHCA) events are associated with lower survival and poor neurologic outcomes (1). For ward patients on centralized telemetry, telemetry technicians notify nursing staff of life-threatening arrhythmias immediately so nursing can verify a patient’s clinical status and determine whether code blue activation is necessary. Delays in this verification [...]

Background: Current practice standards regarding telemetry utilization do not address the usage of telemetry for non-cardiac indications in the acute care, non-ICU, setting. The American Heart Association (AHA) practice standards make no recommendation on the use of cardiac monitoring for non-cardiac conditions (non-AHA) with the potential for hemodynamic decompensation, such as sepsis, gastrointestinal bleeding, alcohol [...]

Background: Studies addressing the utility of cardiac telemetry monitoring for patients hospitalized with COVID-19 pneumonia (PNA) is sparse. Patients hospitalized with COVID-19 PNA are at higher risk for cardiac complications (1-3), thus many hospitals instituted mandatory cardiac telemetry monitoring for patients hospitalized with COVID-19 PNA. However, there is scant data assessing the utility of cardiac [...]

Background: The Society of Hospital Medicine’s Choosing Wisely guidelines recommend regular assessment of inpatients’ need for urinary catheters and telemetry monitoring. Since studies suggest clinicians are not aware which patients have an indwelling catheter or are on telemetry, we aimed to use the electronic patient list to improve cognitive awareness of unnecessary urinary catheters and [...]

Background: Alarm fatigue is a serious patient safety issue and represents a 2015 National Patient Safety Goal.  False alarms can mask true alarms, and may contribute to suboptimal patient care practices.  Cardiac telemetry monitoring in particular has been a focus in the Choosing Wisely campaign and at our institution. Purpose: A comprehensive, multidisciplinary approach was [...]

Background: The number of hospitals with dedicated observation units has grown in recent years to one-third of all United States hospitals and 80% of academic medical centers, though much is still unknown about how to best deliver care in this setting. At our institution, syncope is among the most common indications for admission to the [...]

Background: Inpatient telemetry monitoring began over 4 decades ago. However, recently hospitals have started to implement programs that aim to improve the appropriateness of telemetry use. Quality initiatives take the American Heart Association (AHA) guidelines for practice standards for EKG monitoring in hospital settings to reduce the numbers of patients on telemetry inappropriately.  Our residency [...]