Telemetry or Cardiac Monitoring

The category of Telemetry or Cardiac Monitoring covers the role and responsibilities of the medical-surgical nurse in caring for the patient with cardiac telemetry monitoring. These patients require this monitoring and may need intravenous therapy drips, arterial lines, and central venous pressure lines. Special training allows nurses on a medical-surgical unit to interpret patient cardiac rhythms.

Photo: "The Many Faces of AMSN Members," taken at a recent annual convention.

Question: Should a medical telemetry unit be allowed to administer non-titrated IV drips such as Cardizem or Dopamine? If so what are the guidelines for administration?

Answer: There is very little in the literature that specifies where certain medications can be administered, only hospital specific guidelines. Our recommendation is that your hospital use an interprofessional team to develop a guideline for the administration of these medications.

Question: There are times when there is an overflow of telemetry patients and another floor is opened to accommodate the overflow... nurse has to call tech to see what pattern patient is presenting...

Answer: A variety of facilities utilize different approaches-some offer remote monitoring with the use of a telemetry technician, some utilize the traditional method of the nurse being the primary monitor, and thirdly, some facilities use a blended approach...

Question: Should IV push Lopressor be given on medical/surgical units where there is no cardiac monitoring?

Answer: Our review reveals that the best practice is to ensure the patient receiving Lopressor has a cardiac telemetry monitor in place...

Question: Is there a position statement/policy or best practice from any organization on a safe communication plan for remote cardiac telemetry monitoring on a med-surg unit?

Answer: The standard of practice is that telemetry technicians are trained either through a hospital-based program or an institutional program (such as those credentialed by the Commission on Accreditation of Allied Health Professionals)...

Question: Is there a trend to be seeing full telemetry in hospitals, meaning medical surgical units would be full telemetry? Our hospital is working toward this. Does the AMSN have a stance on this?

Answer: Implementation of telemetry on general medical-surgical units is a trend we are seeing across the country. AMSN does not have a position statement on this, nor were we able to find one in our literature search...

Question: Can you please tell me the acceptable standards for use of a telemetry technician?

Answer: The standard of practice is that telemetry technicians are trained either through a hospital-based program or an institutional program (such as those credentialed by the Commission on Accreditation of Allied Health Professionals). Facility based programs...

Question regarding: Medical surgical units and remote telemetry area overseen by cardiac stepdown unit...

Answer: Hospitals queried have dedicated telemetry units, with admission criteria deeming the patient appropriate for that unit...