NR 439 Week 2 Graded Discussion Topic:
Research, Practice Problems, and Questions
Week 2 Discussion Topic NR 439
1. Reflect on your practice, and identify a significant nursing clinical issue or change project that
you would like to search for evidence in online sources. Formulate searchable, clinical questions
in the PICO(T) format for your nursing clinical issue.
2. Next, review the guidelines for the PICO(T) Assignment due week 3. Use your PICO(T) elements
to search for one report of a single, original study that has been published within the last 5 years
from the CCN Library that is relevant to your nursing clinical issue.
3. Briefly describe how it is relevant to your nursing clinical issue. Remember to give complete
reference to the study.
With working on a telemetry step down unit, I’ve noticed that there are multiple types
of alarms that go off during a normal work day. Sounds of vents bucking or disconnecting, call
lights, bed alarms, our new avasys video monitors that watch patient who are at high risk of
climbing out of bed, IV pumps and our cardiac monitoring system just to name a few. With all of
these alarms constantly going off, there is a higher risk for nurses to not immediately react to
certain alarms sounding since they appear all to frequently. This can become an issue and be
detrimental to our patients. My facility has taught members of the team to sit and specifically be
our monitor technicians to continuously monitor the cardiac rhythms of our patients.
According to Houser, “Of primary importance to the selection of an approach is the nature of the
research question” (Houser, pg. 37). Based on developing the PICO(T) formatted question, my
question is:
- By working on a telemetry unit with continuous tele monitoring, how can we reduce
nonaction required alarms from sounding and prevent inessential actions for cardiac
monitoring?
In the article that I read, by Mary Jahrsdoerfer called Case Study Reducing Interruption
Fatigue through Improved Alarm Support, she mentioned that the floors they conducted the
study on modified their telemonitoring systems to be customized for specific patients based on
clinical circumstantial need. The article also included a system of changing cardiac leads daily
with proper skin prep to prevent artifact from occurring and setting unnecessary alarms off. In
the article, they of course set alarms for the life threatening rhythms such as “asystole,
ventricular tachycardia, ventricular fibrillation, extreme tachycardia, extreme bradycardia, apnea,
and oxygen desaturation” (pg. 111). Ultimately, from the results I read, they were able to reduce
the alarms up to 25% by altering the settings per patient. This article utilized a quasiexperi-
mental study by analyzing an ICU unit, a progressive unit and two telemetry units for a total of
52 beds.
References:
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones
and Bartlett.
Jahrsdoerfer, M. (2016). Reducing Interruption Fatigue through Improved Alarm Support. Biomedical
Instrumentation & Technology, 50(2), 109-113.
Research, Practice Problems, and Questions
Week 2 Discussion Topic NR 439
1. Reflect on your practice, and identify a significant nursing clinical issue or change project that
you would like to search for evidence in online sources. Formulate searchable, clinical questions
in the PICO(T) format for your nursing clinical issue.
2. Next, review the guidelines for the PICO(T) Assignment due week 3. Use your PICO(T) elements
to search for one report of a single, original study that has been published within the last 5 years
from the CCN Library that is relevant to your nursing clinical issue.
3. Briefly describe how it is relevant to your nursing clinical issue. Remember to give complete
reference to the study.
With working on a telemetry step down unit, I’ve noticed that there are multiple types
of alarms that go off during a normal work day. Sounds of vents bucking or disconnecting, call
lights, bed alarms, our new avasys video monitors that watch patient who are at high risk of
climbing out of bed, IV pumps and our cardiac monitoring system just to name a few. With all of
these alarms constantly going off, there is a higher risk for nurses to not immediately react to
certain alarms sounding since they appear all to frequently. This can become an issue and be
detrimental to our patients. My facility has taught members of the team to sit and specifically be
our monitor technicians to continuously monitor the cardiac rhythms of our patients.
According to Houser, “Of primary importance to the selection of an approach is the nature of the
research question” (Houser, pg. 37). Based on developing the PICO(T) formatted question, my
question is:
- By working on a telemetry unit with continuous tele monitoring, how can we reduce
nonaction required alarms from sounding and prevent inessential actions for cardiac
monitoring?
In the article that I read, by Mary Jahrsdoerfer called Case Study Reducing Interruption
Fatigue through Improved Alarm Support, she mentioned that the floors they conducted the
study on modified their telemonitoring systems to be customized for specific patients based on
clinical circumstantial need. The article also included a system of changing cardiac leads daily
with proper skin prep to prevent artifact from occurring and setting unnecessary alarms off. In
the article, they of course set alarms for the life threatening rhythms such as “asystole,
ventricular tachycardia, ventricular fibrillation, extreme tachycardia, extreme bradycardia, apnea,
and oxygen desaturation” (pg. 111). Ultimately, from the results I read, they were able to reduce
the alarms up to 25% by altering the settings per patient. This article utilized a quasiexperi-
mental study by analyzing an ICU unit, a progressive unit and two telemetry units for a total of
52 beds.
References:
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones
and Bartlett.
Jahrsdoerfer, M. (2016). Reducing Interruption Fatigue through Improved Alarm Support. Biomedical
Instrumentation & Technology, 50(2), 109-113.
