SHM Converge Scientific Abstract ePoster Gallery-Telemetry Monitoring for Non-Cardiac Conditions in the Acute Care Setting

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This study examined telemetry use for non-cardiac conditions in an acute care, non-ICU setting across a 10-hospital academic health system. The authors note that American Heart Association (AHA) telemetry standards do not address many common non-cardiac indications such as sepsis, gastrointestinal bleeding, alcohol withdrawal, respiratory failure, and postoperative monitoring, leading to variable practice and possible overuse.<br /><br />Using a clinical decision support tool embedded with AHA guidelines and a write-in option for non-AHA indications, the team analyzed telemetry orders over a 6-month period. Among 18,787 telemetry orders, 2,594 admissions (13.8%) had a non-AHA indication. The most common reasons were respiratory failure, sepsis, post-noncardiac surgery, GI bleeding, and alcohol withdrawal.<br /><br />Patients with non-AHA telemetry indications had outcomes that were intermediate between those with guideline-concordant telemetry and those with no telemetry. Compared with AHA-concordant telemetry patients, they had lower ICU transfer rates, similar length of stay, and slightly lower in-hospital mortality. However, compared with patients who received no telemetry, they had substantially higher ICU transfer rates and mortality, suggesting that these patients were sicker than the general hospital population.<br /><br />The findings highlight that about 14% of telemetry use falls outside AHA indications. Standardizing ordering to AHA guidelines may help identify evidence gaps, but the study also suggests that non-cardiac telemetry recipients represent a higher-risk group. The authors conclude that prospective trials are needed to determine whether telemetry improves outcomes in common non-cardiac conditions, especially regarding mortality.

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James Grace

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Author List April Sell, Brian Hilliard, Christopher Tignanelli, Debbie Pestka, Genevieve Melton-Meaux, Iva Ninkovic, James Grace, Joe Koopmeiners, Maya Peters, Michael Usher, Nathan Shippee, Nick Ingraham, Sarah Alabsi, Timothy Beebe

Category Research

Concept AHA Telemetry Practice Standards

Concept Continuous ECG Monitoring

Concept Non-AHA Telemetry Orders

Concept Non-cardiac Indications

Concept AHA 2017 Telemetry Guidelines

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author James Grace

Track Outcomes Research

Keywords

telemetry

non-cardiac conditions

acute care

AHA guidelines

clinical decision support

sepsis

respiratory failure

gastrointestinal bleeding

alcohol withdrawal

postoperative monitoring

AHA Telemetry Practice Standards

Continuous ECG Monitoring

Non-AHA Telemetry Orders

Non-cardiac Indications

AHA 2017 Telemetry Guidelines