Date of Graduation

Summer 8-17-2015

Document Type

Project/Capstone

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Dr. Capella

Abstract

Prolonged QTc is recognized as a precursor to Torsades de Points and other lethal ventricular arrhythmias. 52% or patients in critical care units have prolonged QTc and 69% or critical care patients have risks of developing QTc. Many commonly administered medications in the critical care unit are known to prolong QTc yet a microsystem assessment and a gap analysis revealed only 3% of the patients in the surgical ICU had the QTc calculation performed and assessed by the critical care nurse.

The global aim is to improve patient safety by incorporating calculating of the QT correction (QTc) into the regularly performed assessments of the patients in the Surgical Intensive Care Unit. Performing this measurement will identify prolonged QTc, a known precursor to Torsades de Pointes and other lethal ventricular arrhythmias. Critical care nurses and the interdisciplinary team will intervene proactively for these critically ill patients. The specific aim is to reach 90% compliance with calculating and documenting the QTc by September 1, 2015.

Nursing education through staff huddles, educational fliers, and one on one demonstration was provided throughout July 2015. Through interventions to improve nurses’ awareness of QTc calculation and risks of prolonged QTc intervals, compliance with calculating QTc has improved from 3% to 82%. Surveys were administered pre and post education which showed nurses self-reported comfort level has increased from 75% to 95% with no one reporting least comfort at the end of the intervention.

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