Accuracy of detection of clinically important dysrhythmias with and without a dedicated monitor watcher

BACKGROUND: Although dedicated monitor watchers are used in many progressive care units with telemetry monitors, this costly practice has not been evaluated. OBJECTIVE: To compare the accuracy of detection of clinically important dysrhythmias with and without a dedicated monitor watcher. METHODS: On a 26-bed cardiac progressive care unit, documentation of four categories of dysrhythmias during a 7-week period when a monitor watcher was present was compared with that during a 7-week period when no monitor watcher was present. The Hewlett-Packard CareVue Clinical Event Review, a full-disclosure system, was used as the gold standard. RESULTS: Accuracy of detection of nonsustained ventricular tachycardia, supraventricular tachycardia, and pauses was significantly better with a monitor watcher than without. Although the detection of life-threatening rhythms was correct a higher percentage of the time with a monitor watcher, the difference was not significant. CONCLUSIONS: The efficiency and quality of patient care can be enhanced by using a dedicated monitor watcher. The results of this study raise the question of whether improved accuracy of detection of dysrhythmias results in better outcomes for patients.