Abstract 2150: Optimizing Bedside ECG Monitoring with a Disposable Wireless System
Background: Traditional ECG (TECG) monitoring harbor organisms increasing the incidence of nosocomial infections and false alarms in the clinical setting. This study compared TECG to a disposable wireless system (DWS) for alarm accuracy and reproducibility of 12 Lead ECG recordings.
Methods: Bacterial growth was studied by culturing all 20 intensive care bedside ECG lead wires prior to patient use after being disinfected (using standard protocol). The snaps of the lead wires were cultured using trypic sory broth (TSB) with a 12–24 hour incubation period in two separate Petri dishes. Organism growth was recorded after 48 hours. 47 patients were studied for alarm accuracy and 12 Lead ECG recording. Patients were monitored in12 hour intervals using both systems. Alarms were analyzed using Chi-square test. Three 12 lead ECG’s were recorded during each interval.
Results: 6 of the 50 cultures had no growth. 70 microorganisms were isolated from 44 cultures. Of these 75% (n=33) were positive for coagulase negative staphylococcus, 18% (n=8) vencomycine sensitive Enterococci species, 9% (n=4) Methicillin sensitive Staphylococcus aureus, 5% ( n=2) Vancomycine resistant Enterococci, 2% (n=1) highly resistant Acinetobacter baumanii, and 23% ( n=10) other organisms including, Clostridium, Flavimonas, Diptheroids, Enterobacter, alpha Streptococci, Pseudomonas. 75% (53/70) of the organisms were resistance to one or more antibiotics. 513 alarm events occurred with the TECG system. 73% (n=374) were true patient alarms and 27% (n=139) caused by motion artifact, poor connections, or poor skin preparation. 400 alarms occurred with the DWS. 83% (332) were true and 17% (n=68) were false alarms caused by the same factors. There was a statistically significant difference in false alarms between both systems (p<0.001); odd ratio (95% CI);1.8 (1.3–2.5). Reproducibility of 12 lead ECG’s were not statistically significant (p= 0.11)
Conclusion: Traditional ECG lead wires are a reservoir source for multidrug resistant organisms and may result in invasive infections. Disposable wireless systems improves alarm accuracy and provides consistent lead placement for 12-lead ECG recording. This may result in nurses time savings and provides reliable ECG monitoring.