The purpose of continuous ST-segment monitoring is to provide an alert for potential ischemia.

In 1999, Drew et al11 published consensus guidelines recommending use of continuous ST-segment monitoring for specific cardiac patients. However, these guidelines have not yet uniformly become the standard of practice.

To aid in implementing consensus guidelines, we describe a nurse-directed hospital-wide protocol with interdisciplinary agreement on continuous ST-segment monitoring. We begin with a review of current guidelines for continuous ST-segment monitoring among hospitalized patients. Results of a brief survey of hospital use of continuous ST-segment monitoring in our community are provided to facilitate discussion of the extent of implementation of the guidelines into practice. We also review research studies and discuss current limitations of continuous ST-segment monitoring. Finally, we present implications for further research to clarify best-practice use of continuous ST-segment monitoring.

Although the 12-lead electrocardiogram (ECG)...

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