Remote monitoring. Expanding a successful system.

A successful telemetry placement system moves into five medical/surgical areas and two step-down units. The updated equipment included an alarm gateway with an arrhythmia detection system. Telemetry signals are transmitted to a pager worn by nurses; remote display monitors allow nurses to eyeball arrhythmias and reset their alarm without going to a central station.

Remote telemetry: new twists for old technology.

Availability of telemetry beds was increased cost-effectively by providing telemetry on medical/surgical units with remote monitoring at designated critical care areas. Guidelines were developed for patient selection, education, clinical policy and procedure. A two-hour inservice was completed by all medical/surgical nurses and after a pilot study the system was implemented on three medical/surgical units.

Fatigue associated with congestive heart failure: use of Levine's Conservation Model.

This study aimed to refine and extend the findings of an original study which focused on the description of fatigue associated with congestive heart failure. A descriptive approach based on Levine's Conservation Model provided both quantitative and qualitative data. Qualitative data addressed personal integrity and quantitative data measured energy conservation, structural and social integrity. Patients described fatigue as being tired and exhausted and containing both physical and emotional components. Fatigue occurred as a result of stress, physical activity and disease. Patient-identified interventions included rest, distraction, medicine, and physical and spiritual activities. Age, pH and oxygen saturation were significantly related to fatigue. The findings are examined using the concept of adaptation as defined by Levine. Implications for nursing are discussed within the framework of the Conservation Model with emphasis on a holistic approach to patient care.