Abstract 18317: An Interactive Online Education Program Improves Knowledge of ECG Monitoring: Findings From the PULSE Trial
Introduction: Evidence suggests that ECG monitoring practices are inconsistent and inadequate, which may be due to knowledge deficits of nurses. We evaluated whether an interactive online education program improves knowledge related to ECG monitoring.
Methods: The PULSE Trial is a 5-year multi-site randomized clinical trial with crossover to evaluate the effect of implementing the AHA practice standards for ECG monitoring on nurses’ knowledge, quality of care, and patient outcomes. We report data related to nurses’ knowledge from all 3 phases. The sample included nurses on cardiac units in 14 hospitals. After nurses completed a validated 20-item knowledge test, hospitals were randomized to the experimental or control group. Experimental group nurses completed the education program that covered essentials of ECG monitoring and arrhythmia, ischemia, and QT interval monitoring. They then re-took the knowledge test. In phase 3, 12-18 months later, experimental group nurses re-took the test to evaluate knowledge retention and control group nurses took the education program and test. We used mixed modeling to address repeated measures and hospital intra-correlation.
Results: The sample contained 2,560 unique nurses (90% female, 75% white, mean age 38±11 years).
Mean test scores improved (p<.0001) in both groups (71.2) immediately after the intervention, but declined to 61.1 12-18 months later in the experimental group. This was lower (p<.0001) than right after the intervention, but higher (p<.0001) than before. Of the 4 subsections of the test, essentials of ECG monitoring had the highest mean post-test scores (77) and ischemia monitoring had the lowest (56). The pattern of change for all subsections was similar to the entire test.
Conclusions: Although test scores improved after the education, gains diminished over time, but were better than at baseline. Whether the improved knowledge translates into better quality of care and patient outcomes will be determined.
- © 2013 by American Heart Association, Inc.