Literature Review


According to Beery (1998), nurses outside of critical care are being asked to take care of patients with cardiac dysrhythmias. These nurses need to have more than a basic understanding of the fundamentals of cardiac monitoring, and dysrhythmia interpretation. It is essential that institutions have emergency policies and procedures in place, along with a continuing competency education program and yearly refresher programs. The programs should include validation of dysrhythmia interpretation skills and problem solving of case studies.

Nurses have significant diagnostic influence in the areas of cardiac rhythm monitoring and dysrhythmia identification (Hebra, 1994). It is essential that nurses who care patients at risk for cardiac dysrhythmias have a thorough understanding of accurate electrode placement. They must also use current principles when determining the optimal leads to use in monitoring specific types of dysrhythmias.

ECG monitoring is becoming more common in both inpatient and outpatient care settings (Scrima, 1997). Nurses are asked to be responsible for cardiac patients, including monitoring and interpreting cardiac dysrhythmias. They must develop critical thinking skills that help them evaluate the significance of these dysrhythmias. A thorough understanding of cardiac anatomy, physiology and properties can provide a framework for understanding and interpreting cardiac rhythms.

Critical care nurses also need to maintain and enhance ECG skills. Keller Buchanan, K. and Raines, D. (2005) published a qualitative study of critical care nurses which indicated that the skills necessary to recognize and treat arrhythmias could be catagorized as basic, intermediate or advanced. Identification of specific arrhythmias including heart block, aberrant conduction, and tachyarrhythmias varied across training and experience levels within the test sample.


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Nurses outside the critical care settings do not need to master ECG dysrhythmia interpretation.

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