2015, Number 1
Nursing consultation for remote monitoring of patients with implantable cardiac devices
Full text
Language: Spanish
References: 14
Page: 28-34
PDF size: 206.99 Kb.
ABSTRACT
A better compliance with clinical practice guidelines and technological advances implemented in cardiac devices improve the quality of life and survival of patients carrying them. These patients require periodic monitoring as a part of the therapeutic process, but the complexity of their control, the frequent security alerts from generators and electrodes, the increase in the number of carriers, fill up the consulting rooms, and consequently the interval between checkups needs to be longer. Remote monitoring it is a system that provides remote, real-time, comprehensive information about the condition and operation of implantable cardiac devices, and allows patient’s management to be optimized, unnecessary displacements to be avoided and healthcare costs to be reduced. Objectives: To evaluate the current clinical practice on monitoring and the nursing roles, and review and redesign our monitoring protocol as an area of improvement. Methodology: A bibliographical search was conducted using the MeSH descriptors: implantable defibrillator, artificial pacemakers, remote monitoring and nursing care, in the databases: Medline, Embase, Cochrane, CINAHL take care and bounded to the papers published in the last six years. The search is based on the review of new organizational models for remote monitoring, the results thereof were analyzed and a critical evaluation of our interventions was made in order to update our nursing consultation protocol. Results: The current guidelines to reduce variability of care define the objectives, frequency, content and functions of the remote monitoring of the professionals involved. Based on the evidence and our experience, has been updated the protocol of care for these patients. Conclusions: Remote monitoring requires skilled nursing professionals in cardiac stimulation, with ongoing training and essential roles, so as to improve the efficacy of follow up, make an early identification of risk situations in order to anticipate clinical decisions, avoid unnecessary displacements and reduce costs, all of which are highly important and significant aspects in healthcare. The nursing action should be based on evidence and current guidelines in order to encourage excellence in the care of these patients.REFERENCES
Brignole M, Auricchio A, Barón-Esquivias G, Bordachar P, Boriani T, Breithardt OA et al. 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace. 2013; 15(8): 1070-1118.
Wilkoff BL, Auricchio A, Brugada J, Cowie M, Ellenbogen KA, Gillis AM et al. HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs): description of techniques, indications, personnel, frequency and ethical considerations: developed in partnership with the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA); and in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA), the European Society of Cardiology (ESC), the Heart Failure Association of ESC (HFA), and the Heart Failure Society of America (HFSA). Endorsed by the Heart Rhythm Society, the European Heart Rhythm Association (a registered branch of the ESC), the American College of Cardiology, the American Heart Association. Europace. 2008; 10(6): 707-725.