Wireless Cardiac Device Monitoring
Presented by:Ashley D. Solomon, RN
Nursing 457: Nursing InformaticsFall 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 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
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?
Patient Implanted Cardiac Device (Pacemaker, ICD, etc.) Wireless Transmitter Device
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:
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 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
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/our-therapies/defibrillators/index.html.
WebMD. “Abnormal Heart Rhythms and Pacemakers”.
Retrieved October 11, 2009. http://www.webmd.com/heart-disease/abnormal-rhythyms-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.carle-clinic.com/Heart/Documents/EHTC1208_CardiacDeviceClinicBro09.pdf.
Boston Scientific. 2009. “ICD Systems and Leads from Boston Scientific CRM”. Retrieved October 11, 2009. http://www.bostonscientific.com/Device.bsci?page=ResourceDetail&navRelId=1000.1003&method=DevDetailHCP&id=10106021&resource_type_category_id=1&resource_type_id=91&pageDisclaimer=Disclaimer.ProductPage.