Date of Conferral

3-28-2025

Date of Award

March 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Patricia Schweickert

Abstract

This clinical practice guideline (CPG) project was developed for best utilization of telemetry. In order to diagnose arrhythmias and ischemic changes in the heart, continuous cardiac monitoring or telemetry is crucial. The practice-focused question was, “Does the evidence support the development and quality scoring of a CPG using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, that is also approved for use in the practice setting by end users?” The purpose of this doctoral project was to create a CPG to offer the best evidence for practice and optimal approaches to improve the effective utilization of telemetry in the project organization. The Johns Hopkins Evidence-Based Practice model was the analytical strategy for the literature review. A comprehensive search was performed across five databases: PubMed, EBSCOhost, Google Scholar, Cochrane Review, and Epistemonikos. A total of 20 peer-reviewed articles published from 2019-2023 supports the project. A four-member expert panel reviewed the CPG using the AGREE II framework. Domain scores ranged from 97% to 75%, indicating a quality score for this CPG. The global scores reflected overall quality of 85% and 100% approval by end users for use in practice. Recommendations resulting from this project include electronic health record integration, an educational program for staff, and institutional policy changes to support adherence to telemetry monitoring guidelines The potential implications for nursing practice, positive social change, diversity, equity, and inclusion are averting superfluous and expensive diagnostic investigations, mitigate alarm fatigue exhaustion, alleviate the overcrowding in emergency departments, and alleviate the financial strain on healthcare institutions.

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