Perioperative ECG Lead Placement

Abstract

Patients in the perioperative setting are susceptible to incorrect ECG lead placement due to a variety of obstacles such as chest tubes and bandages, as well as surgical sites and positions. Inaccurate and/or inconsistent ECG lead placement has the potential to result in incorrect, missed, or delayed patient diagnosis. This may lead to unnecessary interventions, increased cost of care, and poor patient outcomes. This Doctor of Nursing Practice project assessed the perceived efficacy of a standardized educational aid designed to streamline ECG lead placement and increase consistency among cardiac intensive care unit nurses. A pre-intervention questionnaire, ECG lead reference tool, and voice over presentation were electronically delivered to potential participants who were asked to implement the reference tool in their current practice for two weeks. A post-intervention survey was then electronically delivered to participants for completion, with results collected and analyzed using Qualtrics software. The plan, do, study, act cycle was used to guide this quality improvement project. Participants in the pre- and post- intervention groups consistently reported decreased confidence when placing ECG leads in alternative positions such as lateral or prone. Due to the large discrepancy between the number of pre- and post-intervention participants, no conclusions could be made regarding its impacts on perceptions surrounding ECG lead placement accuracy. This project was helpful in determining nurses’ perceived confidence levels when applying ECG leads in various positions. Future recommendations include repeating this project with expansion of potential participants to include nursing assistants who also apply ECG leads in the clinical setting.