Barriers to Electrocardiographic Monitoring Practice Among Nurses: A Scoping Review

Despite the evidence of the importance of a good use of the electrocardiographic monitoring (ECG-M) to safe and quality patient care, best practices on ECG-M seem to remain a problem for nurses. The aim of this study was to identify and map the barriers faced by the nursing team in performing ECG-M, as well as the strategies to overcome them. Scoping review according to the recommendations of the Joanna Briggs Institute Manual. The databases used were: Medline, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHAL), Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus, and Cochrane. The keywords "Electrocardiography," "Hemodynamic Monitoring," "Nursing," and "Nursing Team" and associated terms were used to find articles published from January 2014 to December 2022, without language restriction. An iterative team approach enabled screening, data selection, and extraction studies that were mapped. Twenty-nine articles were selected and analyzed, and the main barriers were a lack of knowledge and/or skills, as well as difficulty in retaining capacity after an educational intervention. Barriers to adequate cardiac monitoring were related to knowledge and interpretation of ECG-M data, as well as technical aspects related to monitoring. Continuing education strategies, establishment of institutional protocols, and customization of monitoring parameters have been shown to be effective in implementing best practices for ECM.