Accurate ST-segment monitoring can detect silent ischemia and result in changes in clinical management. Changes in the ST segment also add prognostic information that can influence treatment decisions. A lack of awareness is apparent with respect to recommendations for ST-segment monitoring, and ST-segment monitoring is underused in clinical practice. Accurate ST-segment monitoring requires nurses to have a high level of knowledge and skill for accuracy and for effective clinical decision-making.

Ensure proper placement of electrocardiography (ECG) electrodes.

Provide proper skin preparation for ECG electrodes; change electrodes daily.

Perform ST-segment monitoring for patients with acute coronary syndrome for at least 48 hours.

Select monitoring leads according to the patient’s needs and risk for ischemia and/or dysrhythmia.

Use continuous ST-segment monitoring of all 12 leads or ST-segment mapping if available.

Use leads known to show recent injury or ischemia in patients with acute coronary syndrome...

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