Yale Receives $3.9 Million Federal Grant to Improve Heart Monitoring in Hospitals
New Haven, CT — August 8, 2008
New Haven, Conn. - Teaching nurses to make optimum use of electrocardiographic (ECG) monitoring is the goal of a $3.9 million research grant awarded to Professor Marjorie Funk of Yale University School of Nursing (YSN). This is the largest grant ever awarded to a researcher at YSN.
The funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health will enable Professor Funk and her co-investigator, Professor Barbara Drew of the University of California–San Francisco School of Nursing, to conduct a five-year, 16-hospital clinical trial. The study will test the effect of implementing new practice standards for ECG monitoring.
Professors Funk and Drew will provide an interactive online ECG monitoring education program they developed for nurses and use nurse "champions" in the hospital units to reinforce what the nurses learn in the online program. The long-term goal of the study is to improve nursing practices related to ECG monitoring for more accurate diagnosis and more timely treatment, which may lead to better outcomes for patients.
Since the introduction of ECG monitoring in hospital units 45 years ago, the goals of monitoring have expanded from simple tracking of heart rate and basic heart rhythm to the diagnosis of complex arrhythmias and the detection of ischemia of the heart muscle. Over the same 45 years, there have been major improvements in ECG monitoring technology. Modern ECG monitoring equipment is complex and has the capacity to do so much that often nurses do not take full advantage of all the features. The ECG contains a wealth of diagnostic information routinely used to guide clinical decision-making in hospitalized patients, and is noninvasive, inexpensive, and generally always obtainable. Despite the advances in monitoring technology, the need for human oversight in the interpretation of ECG monitoring data remains crucially important.
In hospitals, it is the nurse who is responsible for ECG monitoring. Nurses place ECG monitoring electrodes in precise positions on the patient's chest, determine the goals of monitoring for a particular patient based on diagnosis and risk factors, select the leads to be displayed on the monitor, select alarm parameters, choose whether to invoke the ischemia monitoring option, watch the monitor and evaluate alarms, administer antiarrhythmic drugs, and evaluate the effectiveness of treatment. Errors and omissions can occur at any step in this process. Nurses need to have sufficient knowledge to carry out all these responsibilities in a way that maximizes the quality of patient care and patient outcomes.
"We expect that improved ECG monitoring will result in more accurate diagnosis and more timely treatment, which may lead to better outcomes for patients," Professor Funk added.
