Computer-assisted interventions to improve QTC documentation in patients receiving QT-prolonging drugs

Kristin E. Sandau, Sue Sendelbach, Linda Fletcher, Joel Frederickson, Barbara J. Drew, Marjorie Funk

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background Many medications commonly used in hospitals can cause prolonged corrected QT interval (QTc), putting patients at risk for torsade de pointes (TdP), a potentially fatal arrhythmia. However, documentation of QTc for hospitalized patients receiving QT-prolonging medications is often not consistent with American Heart Association standards. Objective To examine effects of education and computerized documentation enhancements on QTc documentation. Methods A quasi-experimental multisite study among 4011 cardiac-monitored patients receiving QTc-prolonging medications within a 10-hospital health care system was conducted to compare QTc documentation before (n=1517), 3 months after (n = 1301), and 4 to 6 months after (n = 1193) an intervention. The intervention included (1) online education for 3232 nurses, (2) electronic notifications to alert nurses when a patient received at least 2 doses of a QT-prolonging medication, and(3) computerized calculation of QTc in electronic health records after nurses had documented heart rate and QT interval. Results QTc documentation for inpatients receiving QTcprolonging drugs increased significantly from baseline (17.3%) to 3 months after the intervention (58.2%; P< .001) within the 10 hospitals and had increased further 4 to 6 months after the intervention (62.1%, P= .75). Patients at larger hospitals were significantly more likely to have their QTc documented (46.4%) than were patients at smaller hospitals (26.2%; P< .001). Conclusion A 3-step system-wide intervention was associatedwith an increase in QTc documentation for patients at risk for drug-induced TdP, and improvements persisted over time. Further study is needed to assess whether increased QTc documentation decreases occurrence of drug-induced TdP.

Original languageEnglish (US)
Pages (from-to)e6-e15
JournalAmerican Journal of Critical Care
Volume24
Issue number2
DOIs
StatePublished - 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 American Association of Critical-Care Nurses.

Fingerprint

Dive into the research topics of 'Computer-assisted interventions to improve QTC documentation in patients receiving QT-prolonging drugs'. Together they form a unique fingerprint.

Cite this