QT Monitoring in the ICU: A Benchmark Project

In adult Intensive Care Unit (ICU) patients, does QT/QTc monitoring compared to no QT/QTc monitoring affect mortality or ventricular tachyarrhythmia rates during their ICU stay? Not monitoring changes in the QT interval can lead to poor outcomes since mortality rates are higher in patients with arrhythmias (Uvelin, Pejakovic, & Mijatovic, 2017). Approximately 300,000 sudden cardiac deaths occur in the United States each year with an estimated 15,000 because of a lethal ventricular tachyarrhythmia rhythm called Torsades de Pointes (TdP) that occurs when a QT interval is prolonged (Dave, Bessette, & Setnik, 2017). Some risk factors for developing prolonged QT intervals include medication administration, an older age, and electrolyte abnormalities. This QT/QTc monitoring project entails creation of an electronic health record (EHR) flowsheet and Clinical Decision Support System (CDSS), replacing outdated bedside monitors in the ICU and Emergency Department (ED), educating all stakeholders, and go-live with the project. Total expected time for this project from approval to go-live is one year. Major project costs during this time will total approximately $200,000. Return on investment (ROI) would be a profit of at least $550,000 if one lawsuit was avoided. The outbreak of COVID-19 will increase ICU censuses and has a treatment regimen that has the possibility of prolonging QT intervals. QT/QTc monitoring has the ability to reduce incidences of unnoticed QT prolongation that could lead to ventricular tachyarrhythmias and death, saving many lives