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Safety Innovation: Virginia Mason Uses Specially Trained Nurses to Monitor Patients’ Hearts
SEATTLE – (Oct. 30, 2014) – Room 755 at Virginia Mason Hospital isn’t a big space, but it makes a big difference in the care of medical and surgical patients.
Staffed by registered nurses who are specially trained in cardiac care, the room is home to the Remote Cardiac Monitoring (RCM) Support Team. It is equipped with sophisticated technology that wirelessly monitors the ECG, or heart activity, of patients in six hospital medical/surgical units who have been admitted for medical and surgical procedures.
What the patients have in common is a history of heart problems or a risk for arrhythmia and other cardiac issues. Because of these risk factors, continuous heart monitoring is a necessary and additional safety measure for these patients.
This potentially lifesaving service is provided 24 hours a day, seven days a week by the RCM Support Team comprised solely of highly skilled, licensed cardiac registered nurses. Unlike Virginia Mason, many hospitals still use monitor technicians, instead of licensed cardiac nurses, for this essential service. The advantage of having cardiac nurses provide patient surveillance is their ability to quickly evaluate a problem and offer advice to the patient’s primary nurse for the intervention and rescue.
“Our use of cardiac nurses provides an extra margin of safety in caring for our patients,” said Rowena Browman, RN, MSN, director, Cardiac Telemetry. “The RCM nurse immediately notifies the primary nurse when an intervention is needed. Also, the RCM nurse is a key participant with the patient’s nurse and physician in determining steps needed to prevent an individual’s medical condition from deteriorating.”
Patients whose heart activity is monitored by cardiac nurses are on levels 10, 14, 15, 16, 17 and in the Observational Unit of the hospital. The RCM Support Team monitors as many as 50 patients at a time. Patients wear cellphone-size telemetry transmitters that track heart rate and electronically send the information to Room 755. There, watchful cardiac nurses evaluate data from these transmitters in real time as they seek any deviation from baseline heart rhythms.
When needed, a cardiac nurse communicates instantly with the nurse at the patient’s bedside using a wireless communications device that connects caregivers no matter where they are in the hospital.
“The way we have organized our RCM service allows many more patients to receive simultaneous monitoring around the clock,” Browman said. “We are also able to respond quickly as cohesive team to heart-related concerns any time of day or night. Our rapid-response capability supports patient safety and quality care.”
Importantly, centralized heart-monitoring of medical and surgical patients at Virginia Mason allows clinicians to deliver necessary care directly to the patient in their assigned room. Prior to opening of the surveillance center in 2011, medical and surgical patients experiencing heart problems would be transferred to the hospital’s cardiac unit. Patients and clinical teams found this approach disruptive and unsatisfactory.
“The process of moving medical and surgical patients to the cardiac unit limited the unit’s capacity to serve patients whose primary hospitalization was for a cardiac issue,” Browman explained. “Also, unnecessary handoffs occurred and patients were introduced to a whole new care team. After the cardiac problem was addressed, the patient was then transferred back to their room on the medical or surgical floor. This was a source of patient dissatisfaction. Now, we bring the necessary heart service directly to patients in their room. They stay on the floor with the caregivers they have come to know.”
Virginia Mason earned an “A” for patient safety earlier this year from The Leapfrog Group, a nonprofit organization pressing for quality and safety improvements in health care. Leapfrog also designated Virginia Mason as one of the safest hospitals in the United States.
About Virginia Mason
Virginia Mason, founded in 1920, is a nonprofit regional health care system in Seattle that serves the Pacific Northwest. Virginia Mason employs 6,000 people and includes a 336-bed acute-care hospital; a primary and specialty care group practice of more than 460 physicians; regional medical centers throughout the Puget Sound area; and Bailey-Boushay House, the first skilled-nursing and outpatient chronic care management program in the U.S. designed and built specifically to meet the needs of people with HIV/AIDS. Benaroya Research Institute at Virginia Mason is internationally recognized for its breakthrough autoimmune disease research. Virginia Mason was the first health system to apply lean manufacturing principles to health care delivery to eliminate waste, lower cost, and improve quality and patient safety. Virginia Mason website: www.VirginiaMason.org
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Virginia Mason Media Relations