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Daily Electrocardiogram Electrode Change and the Effect on Frequency of Nuisance Alarms

Shue McGuffin, Katherine, DNP, MSN, FNP-C; Ortiz, Sheri, MSN, RN, ACNS-BC, CCRN

Dimensions of Critical Care Nursing: July/August 2019 - Volume 38 - Issue 4 - p 187–191
doi: 10.1097/DCC.0000000000000362

Background In 2018, The Joint Commission identified false telemetry alarms as a significant technology hazard placing patients at risk of injury. Reasons include poor skin preparation when applying electrodes and improper placement of electrodes.

Objectives The purpose of this quality improvement project was to determine if changing electrocardiogram electrodes daily would decrease the frequency of nuisance alarms.

Methods Study design was quantitative/comparative on all patients receiving telemetry monitoring on a 36-bed adult inpatient cardiac telemetry unit. Data collection occurred for 14 days before the intervention and 14 days during the intervention of daily electrode change. Comparison analysis determined if frequency of alarms decreased after the intervention with daily electrode change.

Results Postintervention data showed a 74.15% reduction in telemetry alarms following implementation of a daily electrode change.

Discussion Daily electrocardiogram electrode changes may be an effective strategy for reducing nuisance alarms on telemetry units. Outcomes can be used in conjunction with existing evidence to drive current practice.

Katherine Shue McGuffin, DNP, MSN, FNP-C, is the Doctor of Nursing Practice Program coordinator and clinical assistant professor at The University of North Carolina at Charlotte in Charlotte, North Carolina. She is also a family nurse practitioner with a background in cardiology currently working in Charlotte, North Carolina. Her research interests include quality improvement, doctoral education, cardiovascular nursing, preventive medicine, and early detection and treatment of skin cancer. She is a member of Sigma Theta Tau International, American Nurses' Association, North Carolina Nurses' Association, the American Association of Nurse Practitioners, the Dermatology Nurses' Association, and American Association of Colleges of Nursing.

Sheri Ortiz, MSN, RN, ACNS-BC, CCRN, is a critical care clinical nurse specialist at Caromont Regional Medical Center in Gastonia, North Carolina. She is retired as a major after serving in the US Army Nurse Corps for 23 years. Positions included critical care/trauma nurse, instructor for the US Army Critical Care/Emergency Nursing Course, nurse manager, ROTC Brigade nurse counselor and recruiter, and current role as critical care clinical nurse specialist. Her research interests include cardiology nursing and critical care nursing. She is a member of the National Association of Clinical Nurse Specialists, American Association of Critical-Care Nurses, and Sigma Theta Tau.

No outside sources of funding were used for this project.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Address correspondence and reprint requests to: Katherine Shue McGuffin, DNP, MSN, FNP-C, The University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223 (

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