Most Proposed Topic :
Clinical Safety and Quality Service II (projects aiming to enhance clinical safety and outcomes, clinical governance)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for less than 15 years)
Authors: (including presenting author): :
Tsang JMY(1), Leung YYC(1), Liu YM(1), Chan HL(1), Lee WY(1), Ko KY(1), Chan LY(1), Lam PY(1)
Affiliation: :
(1)Physiotherapy Department, Princess Margaret Hospital
Introduction: :
Telemetry monitoring was implemented in 2021 as part of the Cardiac Rehabilitation Day Programme (CRDP) at Princess Margaret Hospital (PMH). It continuously monitors patients' heart rhythm and heart rate during exercises and could improve the safety of cardiac rehabilitation (CR) by allowing immediate responses to adverse events. Telemetry may also enhance exercise prescription and improve patients’ self-efficacy towards exercise, since about one‐third of Hong Kong Chinese adults are physically inactive with a lower self-efficacy to exercise, thus prone to cardiovascular diseases. Studies have also supported the effectiveness of telemetry, including its use to predict significant cardiac adverse events, with a greater diagnostic yield compared to other monitoring methods such as event loop or Holter monitoring. The extent of the impact of telemetry on enhancing the safety of PMH CRDP and patients’ self-efficacy towards exercise warrants this paper as an evaluation.
Objectives: :
To evaluate the effectiveness of telemetry monitoring in improving the safety and patients’ self-efficacy for rehabilitative exercises prescribed in PMH CRDP.
Methodology: :
To gather evidence that evaluates the effectiveness of telemetry monitoring in enhancing PMH CRDP, such as the change in patients’ self-efficacy towards exercise, and the improvement in the detection of adverse cardiac events. The Cardiac Exercise Self-efficacy Instrument – Chinese version (CESEI-C) scores from October 2021 to December 2023 were retrieved to observe for any trends that telemetry may improve patients’ self-efficacy on exercise. An evaluation of the current practices of telemetry in CRDP is also done to identify any existing practical limitations of telemetry.
Result & Outcome: :
In sum, the mean CESEI-C scores from October 2021 to December 2023 between the initial and final sessions of CRDP increased by 5.59 (p < 0.001), which indicates the patients’ self-efficacy for exercise has improved with the implementation of telemetry. Telemetry also contributes to better management and prevention of adverse cardiac events. Some practical limitations including the potential for human and systematic errors (e.g. placement of electrodes, skin preparation, upper limb activities) may be involved with telemetry use, to which the due courses of action are highlighted to mitigate these errors. To conclude, the benefits of telemetry outweigh its drawbacks in enhancing CRDP, with better patient self-efficacy for exercise and more accurate detection of adverse events.
