Thanks to a new tele-tech position at McKay-Dee’s cardiovascular thoracic unit (CVTU), a patient who was getting ready to be discharged—but whose heart unexpectedly stopped beating for a few seconds—had her care escalated and her life potentially saved.
Brianna Barker, RN
Brianna Barker, RN, had picked up a tele-tech shift on the unit that day, which consists of watching all 27 patient monitors during a 12-hour shift. The tele-tech position is staffed 24/7, ensuring that heart activity of all patients is constantly monitored.
McKay-Dee has had the tele-tech position on the unit since April 2021. In December, McKay-Dee will be the northern telemetry hub, monitoring all five north area hospitals. Tele-tech positions have also been created at other trauma hospitals’ cardiovascular departments in the system.
Brianna says in the past when nurses and techs got busy on the unit, there were times where irregular heart rhythms that needed to be escalated weren’t caught in a timely manner. “Sometimes you’re in another patient’s room and you don’t catch everything on the monitor,” she says. “Things can be missed. We know there have been cases where if patients had been monitored more closely, outcomes would’ve been different.”
During her shift that day, Brianna was watching the monitors when she observed a patient’s heart stop beating for 12-15 seconds and then bounce into a third degree heart block. This is a serious condition where the electrical current in the heart isn’t working properly. In this patient’s case, it was life-threatening and required treatment right away.
“This patient was planning to be discharged within the hour,” says Brianna. “Because of the tele-tech position, I was able to see the problem and get the right people involved. The patient ended up going in for an emergency pacemaker within about 30 minutes.”
“I’d just picked up a shift and happened to be there during that time,” she says. “There have been numerous instances where our patients’ lives have been bettered because of it.”
Prior to the position being created, the same alarm would go off anytime a patient’s heart went into an irregular rhythm—whether it be from obstructive sleep apnea or ventricular tachycardia (V-tach) or cardiac arrest. While the alarm still goes off, today a trained telemetry tech is watching to see exactly what’s happening and can respond immediately.
“Having the tele-tech position allows the team to see the problem and notify the charge nurse in seconds,” Brianna says. “Each patient also has their own report sheet that includes the patient’s rhythm, why they’re here, and who’s taking care of them. It’s just another set of eyes on the floor that are focused on our patients.”
Brianna says while she appreciates being recognized, her supervisor, Ariel De Anda, RN, nurse manager, worked very hard to implement the position.
In addition to Ariel’s work advocating for the position, the EKG team also played an important role, as they took shifts on the unit during training, which was especially helpful when the unit was short staffed. “The EKG team have been great advocates for our patients,” says Ariel. “They were lifesavers.”
Ariel would also like to recognize Celeste Garmire, RN, nurse educator, who worked tirelessly creating the training program and coming in extra to do one-on-one training with the techs. “The CVTU has a great team of dedicated caregivers who always have the patient’s safety as the top priority,” says Ariel.
“This is a great catch and highlights the important responsibility we all have as members of the care team in noticing and preventing a safety event before it reaches a patient,” says David Min, MD, senior medical director of the Cardiovascular Clinical Program. “If it wasn’t for Brianna closely monitoring this patient’s heart activity in this new tele-tech role, this patient’s story might have had a very different, adverse outcome. Kudos to McKay-Dee’s CVTU and everyone who has been engaged in catching these safety concerns.”