PURPOSE: The escalating acuity of the hospitalized patient population is increasing demand for telemetry monitored beds. This demand can lead to an increase in the time patients spend in various locations waiting for a monitored bed, i.e., emergency departments, catheterization laboratories, etc. Additionally, availability of staff to watch monitors is unpredictable due to other responsibilities. For these reasons, implementation of a flexible telemetry monitoring system began at Christiana Care Health System in 2000. All cardiac rhythms and selected physiologic parameters are monitored in a remote location by trained monitor technicians. Utilizing this wireless technology, any patient on any nursing unit in any hospital can be monitored. To assess safety, prospective observations of cardiopulmonary arrest (code) survival rates, including discharge destination, took place for patients monitored by either modality over a 6 year implementation period.
METHODS: From 1/1/00 through 12/31/05 all telemetry code events (n=490) were tracked through a code repository; 342 with traditional telemetry and 148 with flexible telemetry were identified. Code survival indicates patients who survived the event > 20 minutes. Hospital survival indicates patients who survived to discharge; discharged to home includes those with home healthcare. Survival differences were analyzed by a one-sided test of non-inferiority for independent proportions.
RESULTS: Traditional telemetry code survival was 65% (221/342); flexible was 69% (102/148), statistically no different (p=0.038). Traditional telemetry hospital survival was 26% (88/342); flexible was 23% (34/148), statistically no different (p=0.034). Traditional telemetry discharged to home was 57% (50/88); flexible was 50% (17/34), no difference could be established (p=0.5261).
CONCLUSION: The data demonstrates that both forms of telemetry are equally safe and efficacious.
CLINICAL IMPLICATIONS: A flexible telemetry monitoring system is substantially more adaptable for handling a rapid influx of patients without the need for patient transfers or admission delays. It provides continuous observation and arrythmia detection by trained staff, freeing nursing staff to provide direct bedside care, allowing greater utilization of all hospital beds.
DISCLOSURE: Marc Zubrow, None.