New Basic EKG Cards Provide Quick Reference for CV Nurses By Kelli Gifford, Senior Editor
While working as the cardiovascular (CV) service line educator in the Center for Professional Excellence, Donald Yap set a goal to increase staff nurse proficiency in basic EKG rhythm interpretation. After sending out surveys to the acute-care CV units, he discovered many nurses wanted more education on the topic. Yap began creating classes and noticed some experienced RNs were having problems passing the initial basic EKG test during orientation, and some were going to CV units. He saw a need and created cards with EKG information to be handy resource. “I felt that our nurses — and for that matter, any bedside clinician who deals with cardiovascular patient populations — could greatly benefit from a quick reference guide for basic EKG interpretation in addition to the new classes I was developing,” Yap said. “Therefore, I created the cards and collaborated with marketing and legal to get them printed.” The cards’ main focus had to be on basic EKG rhythm interpretation — bedside clinicians need this skill to be able to prioritize care, and, if needed, initiate interventions. However, with rhythm interpretation, information on anatomy, physiology and electrophysiology is required for a full understanding. “One of the big challenges was deciding how much of this information to include since a thick 100-page-or-more book would be too cumbersome to use,” Yap said. “Furthermore, all the content needed to be easy to find, read and comprehend. Therefore, I decided on the ‘Normal, Abnormal, Lethal’ flipbook design for the cards.” The color coding and staggered page format for each section enhances ease of use. The cards have pictures of sample EKG strips for each rhythm coupled with a consistent format so that no matter which rhythm is being referenced, the user can find the desired information quickly. “Basically, I wanted to explain as much about basic EKG rhythm interpretation as possible in a quick, easy-to-understand way and make it relevant for the bedside clinician,” Yap said. The cards are currently in pilot phase in which all graduate nurses (GNs) and new-hire nurses receive a copy. The goal of this initial pilot testing is to evaluate optimal use of the cards. Yap has found that with the cards, more nurses are passing the initial basic EKG test. Prior to distribution of the cards, five to 10 nurses could not pass in each group, he said. They began 6 HOUSTON METHODIST NURSE • WINTER 2016
distribution of the cards in orientation at the beginning of January, and so far in the past three groups, only two nurses have not passed the initial basic EKG test. Yap said he is still deciding on the best and most efficient way to distribute the cards and plans to initially place a copy on every crash cart in the hospital and follow with trials in select units. “I believe the cards have helped and can continue to help nurses achieve a better understanding of basic EKG,” Yap said. “Therefore, my hope is that this will translate into increased confidence and proficiency in rhythm interpretation at the bedside leading to a higher overall standard of care.”