Authors (including presenting author) :
TSE KY(1), HO YKE(1), CHAN PYP(1), SZE-TO TL(1)
Affiliation :
(1)Department of Medicine and Geriatrics (M&G), Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Electrocardiogram (ECG) is the most commonly performed non-invasive diagnostic procedure in medical wards. Proper lead placement ensures the ECG record truly reflects the heart rhythm and is essential for accurate interpretation, diagnosis and management planning. However, improper lead placement is often observed and the existing references are inadequate. Thus, a quick reference was developed to aid nurses on the proper ECG lead placement.
Objectives :
1. To enhance the quality of the ECG recordings.
2. To develop a quick reference with illustrations on proper ECG lead placement.
3. To enhance nurses’ knowledge and confidence in performing different types of ECG.
Methodology :
The project was conducted in two phases with three major components: knowledge quiz, training sessions and a quick reference. Nurses from two medical wards were invited to pilot this project. An experience survey and an 8-question knowledge quiz on ECG lead placement was developed and conducted before and after the training session. The 1-hour training session included practical tips on ECG lead placement and monitoring and introduced the newly designed quick reference included illustrations of different types of ECG lead placement (e.g. right-sided and posterior). Nurses from three medical wards, Intensive Care Unit and Coronary Care Unit were recruited to the second phase. Knowledge quiz and training session were conducted as in the pilot phase. All ECG machines from the participated wards were attached with the quick reference for easy access.
Result & Outcome :
In the pilot phase, 78% of nurses claimed they were confidence in performing different types of ECG, yet the average score of knowledge quiz was about 50%. Nurses’ confidence in performing ECG increased by 20%, up to 98% after the training session, while the quiz average score increased to 84%. The pilot result indicated that enhancing nurses’ knowledge on ECG was worth doing. In the second phase, the pre-quiz average score was 56%. A significant improvement was also observed after the training sessions and the implementation of quick reference. Post-quiz average score increased to 82%. Over 94% of nurses found the quick reference useful and their confidence in performing the different types of ECG increased.
The quick reference is easy to read and useful in daily clinical practice. It helps to improve the quality of ECG recordings which in turns facilitates physicians to make suitable management plan for patients.
