Download Ashley Powerpoint Presentation NURS457

Wireless Cardiac
Device Monitoring
Presented by:
Ashley D. Solomon, RN
Nursing 457: Nursing Informatics
Fall 2009
Objectives:



Define wireless
cardiac device
monitoring (WCDM).
Describe and evaluate
the hardware and
software used in
WCDM.
Describe and evaluate
the different types of
information systems
used with WCDM.
Objectives: (Cont.)


Depict the function of
nursing informatics
when working with
different WCDM
systems in the inpatient
and outpatient settings.
Discuss the advantages
and disadvantages of
WCDM from the
perspective of a
professional nurse.
What is Wireless Cardiac Device
Monitoring?
Implanted Cardiac Devices
*Monitor cardiac rate
*Monitor cardiac rhythm
*Diagnose problems
*Change device settings if necessary
*Follow up can even be performed from the patients own
home!
What is Wireless Cardiac Device
Monitoring? (cont)
•
•
Medtronic
Boston Scientific
What is a Pacemaker?

Pacemaker ~
 Electrodes placed during surgical procedure
 Electrodes deliver electrical shock when indicated
 Regulates beating of the cardiac muscle
What is an Implantable
Cardioverter-Defibrillator (ICD)?

Implantable Cardioverter-Defibrillator ~
 Battery-powered electrical impulse generator
 Device connected to leads inside of the heart or on
the surface of the heart
 Detects ventricular tachycardia or fibrillation and
delivers shock
Equipment Requirements:
Implanted Device
 Portable Wireless
Transmitter
 Home Computer

What Hardware is used?
Pacemaker
Implantable
cardioverterdefibrillator
What Hardware is used? (Cont.)
Wireless Transmitter Device
Wirelessly transmits data from ICD
Information sent to healthcare provider via secure server
•
•
Secure Server
Secure internet connection
Transfer information to healthcare provider wirelessly
•
•
Computer
•
Stores, calculates, relays data wirelessly
What Hardware is Required?



Implanted Cardiac Device (Pacemaker, ICD, etc.)
Wireless Transmitter Device




Patient
Healthcare Provider
Computer
Secure Server
Pager
What Software is Required?
Application Software
• Software required to interpret and display cardiac rhythm,
rate, and waveform
System Software
• Secure server is required to transmit the patients cardiac
information to the physicians office
Programming Software
• Security and anti-virus software is required to maintain
patient privacy
Usability of the software:
Minimal technology is required for the
patient.
 Provides portability for patients and
healthcare providers.
Real-time monitoring capability during all
hours of the day or night.
 Privacy of the patients own home.


WCDM as a Clinical Information
System (CIS)
Clinical Information System (CIS)

Used by physicians, cardiologists, nurses and patients

Functionality



Diagnosis of arrhythmias
Documentation of patients rhythm at any date/time
Point of Care Testing, Work Station, Local Area
Network
Data Standards for WCDM



American Society for Testing & Material
International Standards Organization
International Statistical and Classification of
Diseases and Related Health Problems (ICD-9 or
ICD-10 used for disease classification.
Recommend WCDM systems?

The many advantages to WCDM outweigh the
disadvantages.

Advantages:

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
Minimal Technology is required
Provides portability for all users (physicians and patients)
Increasing portability for patients causes greater
compliance
Real-time monitoring capability 24/7
Disadvantages:


Cost for technology
Possible breach of confidentiality
Legal & Ethical Concerns
Possibility for breach of
confidential information,
security, and privacy
 Patient’s may view this
technology as a
substitute for regularly
scheduled check-up’s
with their physician
 Possibility of equipment
error and failure

Informatics Competencies
Computer Based Learning
Modules
 Yearly competency training
and continuous technology
upgrade demonstration
 Up to date nursing license

Function of Informatics Nurse

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Guide the patient in properly plugging into the computer system
for interpretation
Provide further guidance related to emergency situations
(example: Contacting 911)
Provide call-backs to the patient on any possible changes needed to
be made to the ICD/pacemaker
Communicate with the attending physician regarding the patient’s
care and current condition
Stay up to date on the most current upgrades and trends in WCMD
systems
Provide patient education
Summary



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Advantages of wireless cardiac
monitoring far outweigh the
disadvantages
New technology that is
continuously improving
Convenience and safety for the
patient and healthcare staff
Greater ease of use and
portability will increase patient
compliance
References:
Medtronic. Published April 22, 2009.
Defibrillators
(Implantable). Retrieved September 20, 2009.
http://www.medtronic.com/ourtherapies/defibrillators/index.html.
WebMD. “Abnormal Heart Rhythms and Pacemakers”.
Retrieved October 11, 2009.
http://www.webmd.com/heart-disease/abnormalrhythyms-pacemaker.
References: (Cont.)
Cardiac Device Clinic at The Carle Heart Center. February
2009. “Follow up care for patients with pacemakers and
ICD’s”. Retrieved October 11, 2009. http://www.carleclinic.com/Heart/Documents/EHTC1208_CardiacDeviceClini
cBro09.pdf.
Boston Scientific. 2009. “ICD Systems and Leads from Boston
Scientific CRM”. Retrieved October 11, 2009.
http://www.bostonscientific.com/Device.bsci?page=Resourc
eDetail&navRelId=1000.1003&method=DevDetailHCP&id=1
0106021&resource_type_category_id=1&resource_type_id=9
1&pageDisclaimer=Disclaimer.ProductPage.
References: (Cont.)

My Life Stages. “Sutter North Launches New Wireless
Cardiac Monitoring System.” Published 2008. Retrieved
November 21, 2009.
https://mylifestages.org/sites/MyLifeStages/featuredar
ticle/2009/feb/0209_snmf2_wireless.page.