![[Visit Client Website]](images/banner.gif)
The purpose of this project was to develop an educational program to nurses as they assume cardiac monitoring responsibilities on an adult inpatient Blood and Marrow Transplant unit.
Background:
Blood and Marrow patients are at risk for cardiac toxicities related to the high-dose chemotherapy they receive as part of their conditioning regimen. By initiating cardiac monitoring on the BMT unit continuity of care could be maintained by educating Blood and Marrow Transplant nurses to use the cardiac monitor, manage select arrhythmias and administer specific medications to treat the cardiac situation.
Method:
With no cardiac patients or equipment, our biggest challenge was how to educate nurses to take cardiac patients on day one after our move. We began our multimodal approach with a three day class provided by the critical care orientation team. We prepared a bucket of practice strips, led one to one and group learning sessions, and read 12 lead EKGs to keep our knowledge fresh. All nurses were required to complete a cardiac arrhythmia test with an 80% pass threshold. They also attended a mandatory four hour class run by BMT leadership nurses that included review of rhythms, Cardiac Monitoring Jeopardy, hands-on practice with the monitor, scenarios in our hospital’s simulation laboratory. Once telemetry began, staff members from the hospital’s rapid response team rounded daily to review strip interpretation and consult with nurses as needed.
Results:
A total of 60 nurses completed the program before initiation of cardiac monitoring. All nurses independently care for patients on monitors and use monitors for vital signs. Zero patients have transferred to the telemetry unit and RRT continues support for rhythm checks. We continue to present the cardiac orientation program to new BMT nurses along with precepted time with monitored patients to help them feel prepared for independent practice.