Section 1– Correct lead placement 2
Section 2 - Incorrect lead placement 5
Section 3 – Conclusion and recommendations 7
Recording an electrocardiogram or ECG, is a procedure which is performed daily all over the United Kingdom by thousands of healthcare workers and in particular nurses (Jacobson, 2000). The way in which this procedure is performed varies from geographical location to location and occasionally even more so, between staff on the same ward (Amos, 2000). This reason stated by Amos (2000), formed the basis of my decision to choose this topic.
The recording of an ECG is often seen as a fairly mundane, routine observation as it is non-invasive and does not physically demanding for the patient or member of staff (Cowley, 2002). However, should the leads be placed incorrectly on the patient, they may well end up with inappropriate treatment for their condition. An extensive search of the both written and electronically stored literature showed very little previous research addressing the issues of ECG performance by nurses in general wards.
The key findings as a result of this essay showed that lead placement is fundamental knowledge for all those performing ECG’s, regardless of their ability to interpret ECG’s.
Section One – Introduction and correct lead placement.
For this assignment I have chosen the topic on Electrocardiograph or ECG lead placement. The purpose of this essay was to discover, based on the best and most recent evidence, whether ward nurses can adequately perform twelve lead ECG’s. In this section, a brief introduction to the problem shall be discussed along with the first aim of highlighting how the correct knowledge in lead placement is essential for all those performing ECG’s. Section Two highlights how incorrect lead placement can have an effect on patient management and Section Three offers a conclusion and
References: Amos, L. (2000). Testing nurses knowledge of 12 lead ECG’s. Retrieved September 20, 2003: http://www.clininfo.health.nsw.gov.au/hospolic/stvincents/contents.html Brannigan, D Cowley, M. (2002). A practical guide to ECG monitoring and recording. Retrieved September 20, 2003: http://www.mikecowley.co.uk/leads.htm. Crow, R., Park, L., & Rautaharju P.M. (1998). A standardized procedure for locating and documenting ECG chest electrode positions: consideration of the effect of breast tissue on ECG amplitudes in women. Journal of Electrocardiology: 31, (1):17-29. Dougherty, L. & Mallett, J. (2000). Royal Marsden Manual of Clinical Nursing Procedures. 5th edn. 406-407. Ford, S. (2002). Common errors in clinical measurement. Anaesthesia and Intensive Care Medicine, 34, 2. 466-467. Jacobson. P. (2000). Electrocardiography: a basic introduction. Retrieved September 20, 2003: http://www.abdn.ac.uk/~u10rjl/page3.htm#interpret. Kors. J.A., Meij, S.H,. Nelwan, S.P. & van Dam, T.B. (2001). Correction of ECG variations caused by lead placement. Journal of Electrocardiology 34, (4), 213-216. Lewes, P. (1965). Electrode choice for Electrocardiogram readings. British Heart Journal., 4, (12), 610-615. Nursing and Midwifery Council. (2002). Code of Professional Conduct, retrieved September 20, 2003; http://www.nmc-uk.org/cms/content/Publications/Code%20of%20professional%20 conduct.pdf Appendices