43 Oral Deficiencies in Nurses Knowledge and Substandard Practice Related to ECG Monitoring: Baseline Results of the Pulse Trial
Bibliographic record
Abstract
Purpose: Although ECG monitoring is the cornerstone of care in hospital cardiac units, no studies have evaluated its quality. The purpose of our study is to examine: (1) nurses' knowledge of ECG monitoring; and (2) the quality of ECG monitoring (electrode placement; accuracy of rhythm interpretation; and use of arrhythmia, ischemia and QTc interval monitoring). Method: We analyzed baseline data from the PULSE Trial, a 5-year multi-site randomized clinical trial evaluating the effect of implementing American Heart Association practice standards for ECG monitoring on nurses' knowledge, quality of care, and patient outcomes. To evaluate knowledge, 1,739 nurses working on cardiac units at 17 hospitals (15 in the US, 1 in Canada, 1 in China) completed an online ECG monitoring knowledge test that covered essentials of ECG monitoring and arrhythmia, ischemia, and QTc interval monitoring. Scores can range from 0 to 100, with higher scores indicating greater knowledge. To evaluate the quality of ECG monitoring, 3 research nurses observed 1,821 patients on the cardiac units. They reviewed current medical records, observed patients for electrode placement, and compared arrhythmias stored in the monitor's memory with documentation by unit nurses.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".