NK7
Innovation NK7
Provide one example, with supporting evidence, of an innovation implemented within the organization involving nursing.
Example: AIRSTRIP Telemetry Monitoring System
Innovation within the Organization
Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS) changed its standards of practice in July 2022 with a new, innovative telemetry technology called AIRSTRIP. The AIRSTRIP telemetry monitoring system, used in all SVHS medical/surgical units, enables nurses to review patients’ cardiac rhythms in real time.
AIRSTRIP Patient Telemetry Monitoring and AIRSTRIP Snippets provide a method for digitally documenting cardiology waveforms and transmitting them into the electronic medical record (EMR) system. The conversion to this new, innovative technology eliminates the need to manually scan documentation. AIRSTRIP provides a digital process for capturing the ECG strip using calipers and securely transmits the strip into the CHI SVHS EMR. This technology also enables physicians and nurses to view the patient’s real time heart rhythm from any computer that has access to the EMR. (Evidence NK7-1, End User Training, pg. 2)
Nursing Involvement
In November 2020, Teresa Lambert, MBA, BSN, RN, Vice President of Patient Care Services/Assistant Chief Nursing Officer (role of CNO), CHI SVHS, was concerned that the current telemetry system was at risk to fail. This product was at the end of its life, and the hardware and software were no longer supported by the manufacturer. GE Healthcare was the preferred vendor for CommonSpirit Health (CSH), the overarching company of CHI SVHS. The GE Healthcare CARESCAPE Central Station with the ApexPro Telemetry System was purchased for use in all the medical, surgical, and cardiac patient care areas, and it went live in March 2021.
The newly purchased GE telemetry monitoring system did not interface with the current EMR, requiring a workaround: A monitor technician (MT) had to print a paper ECG cardiac waveform strip every six hours and scan this into the EMR. The process of printing and scanning is time consuming, and scanning can result in a document failing to arrive at the intended designated area in the patient’s EMR. The MT or a nurse would then need to verify that the ECG cardiac waveform strip was in the patient’s EMR. The second issue identified was that there was no way to view a patient’s cardiac rhythm in real time. Physicians and nurses had to either rely on an MT to accurately interpret the patient’s cardiac rhythm or walk to the MT department to view the patient’s cardiac rhythm on the central monitoring station.
Given this quality/safety issue with the new GE telemetry system, the hospital also purchased software from AIRSTRIP, another CSH contracted vendor. This is a data source agnostic company that can provide data transmission and remove the barriers nurses would encounter. AIRSTRIP would also provide a digital ECG picture to view at any computer and a seamless transfer of the patient’s cardiac heart waveforms into the EMR.
In December 2020 a workgroup was formed (see table below) with representatives from Mercy Technology Services (which manages CHI SVHS’s EMR), GE Healthcare Telemetry, AIRSTRIP, and CHI SVHS. The group’s purpose was to plan the implementation of the new, innovative system, plan the management of the secure transmission of patient cardiac ECG waveform data, and develop a GE telemetry and AIRSTRIP training and support plan. (Evidence NK7-2, Training and Support Plan)
Technology/Security Implementation Team
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Name/Credentials |
Discipline |
Title/Role |
Department |
Teresa Lambert, MBA, BSN, RN |
Nursing |
Vice President of Patient Care Services/ACNO |
Nursing Administration |
Dennis Meyer |
Information |
IT Area Manager |
Mercy Information |
Kim Kuzawa |
AIRSTRIP |
Project Manager |
Project Management Office |
Greg Ziemann |
GE |
Project Manager |
GE Healthcare LCS |
Megan Steele, BSN, RN, CNML |
Nursing |
Nurse Manager |
2 East Cardiology |
Lana Lambert, MNSc, RN, ACNS-BC |
Nursing |
Clinical Educator |
Clinical Education |
Betty Irvin, BSN, RN |
Nursing |
Clinical Informaticist |
Clinical Informatics |
The first step was to replace the existing telemetry system with the new GE Healthcare telemetry system. T. Lambert and Clinical Educator Lana Lambert, MNSc, RN, ACNS- BC reviewed telemetry policies in January 2021 to compare the current system with the new GE Healthcare system, and the policies were updated accordingly. The changes were reviewed during education in-services provided to the staff. Training was provided on February 2, 3 and 4, 2021 by GE Healthcare’s clinical educator for patient care technicians, nurses, and MTs. Training was not mandatory, but strongly encouraged by CHI SVHS nurse managers. A total of 225 clinical staff members attended. (Evidence NK7-3, Education In-service Flyer and Sign-in Sheets)
A conference call with workgroup members was held on January 26, 2021 to prepare for the conversion of the telemetry ECG transmitters. L. Lambert reported during the conference call that the CHI SVHS nurse managers had requested a scripted formal exchange plan to provide a safe conversion. There was a safety concern that an ECG telemetry transmitter could be placed on the wrong patient, leading to inappropriate treatment or delays in treatment. In February 2021, CHI SVHS nurse leaders and Information Technology staff, AIRSTRIP representatives, and GE representatives engaged in email communication to plan the various phases of the project. (Evidence NK7-4, Airstrip Emails) the go-live for the conversion to the new GE Healthcare telemetry ECG transmitters was planned for March 2, 2021. The telemetry transmitters were exchanged unit by unit, room by room, with a checklist followed for each patient exchange to ensure secure, safe transfers.
T. Lambert presented information about the implementation of CHI SVHS’s new GE telemetry system and the upcoming addition of AIRSTRIP at the Shared Governance Interprofessional Practice Council on April 7, 2022. Clinical nurses were notified that they would need to attend upcoming education and that the vendor would be on site for the go-live day.
The final step was the training on and implementation of AIRSTRIP for nurses and MTs. Training was conducted on June 28, 29, and 30, 2022 by the AIRSTRIP clinical educator, L. Lambert, and Clinical Informaticist Betty Irvin, BSN, RN. Classes were designed for end users and super users. The trainers used a playground environment for AIRSTRIP and the EMR so the nurses and MTs could view the actual steps to admitting a patient into the AIRSTRIP environment, produce a six-second ECG Snippet and transfer it into the EMR. Nurses and MTs were given tip sheets during the class so they would have information to reference at the bedside when providing patient care and documenting a patient’s cardiac heart rhythm.
The innovative AIRSTRIP technology went live on July 5, 2022. (Evidence NK7-5, AIRSTRIP Epic Tipsheet and Flowsheet Documentation) The feedback following the implementation of AIRSTRIP has been strongly positive. Nurses appreciate being able to see the patient’s ECG cardiac rhythm on the EMR while at the bedside documenting their physical assessment or with any change in their cardiac rhythm. This enables the nurse to physically assess a patient while confirming the ECG rhythm, which promotes real-time charting at the bedside while providing another layer of safety for SVHS patients.
CHI SVHS nurses were excited to have a new state-of-the-art telemetry system, but they were concerned about the documentation process and the inability to view the patient’s cardiac rhythm. The Executive Team partnered with AIRSTRIP, a data source agnostic company, which provides data transmission and removes the barriers nurses were encountering. AIRSTRIP is an innovative process that provides a digital ECG picture to view and a seamless transfer of the patient’s cardiac heart waveforms into the EMR.