Implementation of Practice Standards for ECG Monitoring (PULSE)

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Yale University

Status

Completed

Conditions

Cardiovascular Disease

Treatments

Behavioral: Education

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT01269736
R01HL081642 (U.S. NIH Grant/Contract)
0711003292

Details and patient eligibility

About

The purpose of this study is to test the effect of implementing new practice standards for electrocardiographic (ECG) monitoring on nurses' knowledge and skills, quality of care, and patient outcomes. The investigators hypothesize that increased knowledge and skills of nurses will lead to enhanced quality of care, which will result in improved outcomes for patients.

Full description

Despite advances in hospital electrocardiographic (ECG) monitoring technology, monitoring practices are inconsistent and often inadequate. The investigators recently published practice standards for ECG monitoring. The primary purpose of this 5-year multisite randomized clinical trial is to test the effect of implementing these standards on nurses' knowledge and skills, quality of care, and patient outcomes. The investigators expect that increased knowledge and skills of nurses will lead to enhanced quality of care, which will result in improved outcomes for patients. Units serving cardiac patients in 17 hospitals will participate. Hospitals will be randomized to the experimental or control group after baseline measures of knowledge and skills, quality of care, and patient outcomes are obtained. The intervention will include ECG monitoring education and strategies to implement and sustain change. The online education will include 4 modules: essentials of ECG monitoring, arrhythmia monitoring, ischemia monitoring, and QT interval monitoring. The strategies to implement and sustain change in the clinical area include reinforcement of education, incentives, and the designation of "champions" on each unit who will actively promote the implementation of the practice standards.

Enrollment

92,057 patients

Sex

All

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Nurses (and monitor technicians): All nurses (and monitor technicians) working on participating units serving patients with cardiac disease
  • Patients: All patients cared for on participating units

Exclusion criteria

  • Nurses (and monitor technicians): No nurses (or monitor technicians) will be excluded
  • Patients: No patients on the participating units will be excluded, even if their primary diagnosis is not cardiac

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Crossover Assignment

Masking

None (Open label)

92,057 participants in 2 patient groups

Education
Experimental group
Description:
Online ECG monitoring education program and strategies to implement and sustain change for nurses
Treatment:
Behavioral: Education
Control
No Intervention group
Description:
Usual in-service education for nurses

Trial contacts and locations

16

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Data sourced from clinicaltrials.gov

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