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Increasing Early Cardiac Screening in an Inpatient Psychiatric Setting Using the KardiaMobile 6 Lead Device

Published online by Cambridge University Press:  07 July 2023

Tomasz Pierscionek ,
Gavin Urban  and
Ignatius Loubser
Tomasz Pierscionek*
Affiliation:
Oxleas NHS Foundation Trust, London, United Kingdom
Gavin Urban
Affiliation:
South London and Maudsley NHS Foundation Trust, London, United Kingdom
Ignatius Loubser
Affiliation:
Oxleas NHS Foundation Trust, London, United Kingdom
*
*Corresponding author.
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Abstract

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Aims

The Royal College of Psychiatrists' core standards include a comprehensive physical health review as a vital part of an inpatient admission.

To determine whether using the KardiaMobile 6 lead (KM6L) device on an inpatient psychiatric ward would increase:

  1. a. the percentage of patients who receive an ECG during an inpatient stay

  2. b. the percentage of patients who receive an ECG within 24 hours of admission

Methods

The KM6L device provides a 6 lead ECG recording within 30 seconds. It enables ECGs to be performed more efficiently and less intrusively than a 12 lead ECG machine.

The study aimed to offer all patients (101) admitted to an acute inpatient ward (July 2022 – Jan 2023) an ECG using the KM6L device, unless reporting chest pain, having significant cardiac history, or doctor otherwise concerned – in that event a 12L ECG would be done instead.

The percentage of patients receiving an ECG during an inpatient stay and the percentage who received an ECG within 24 hours of admission were compared on the same ward when using:

  1. a. the KM6L device between July 2022 and Jan 2023; and

  2. b. a 12L ECG between July 2021 and July 2022

QT intervals were calculated manually as the automatic feature is still in development

Results

Between July 2021 – July 2022, using a 12L ECG:

  • • 217 patients admitted

  • • 142 (65.4%) had a 12L ECG during their inpatient stay. Of these, 83 were done within 24 hours of admission (58.5%). Overall, 83/217 (38.2%) of patients had an ECG within 24 hours of admission.

Between July 2022 – Jan 2023, when KM6L device available on ward:

  • • 101 patients admitted

  • • 66* (65.3%) had an ECG during their inpatient stay. Of these, 46 were done within 24 hours of admission (69.7%). Overall, 46/101 (45.6%) of patients had an ECG within 24 hours of admission

*Note: 15/66 patients had a 12L ECG as available clinician did not know how to operate KM6L device

Conclusion

KM6L, despite being easier to use and less intrusive, did not increase the percentage of patients who received an ECG during an inpatient stay. However, there was a notable increase in the percentage of ECGs performed within 24 hours of admission. KM6L offers a cost and time saving alternative for obtaining ECGs; earlier cardiac screening may also reduce risk.

Future work will consider further training of healthcare professionals in how to use the KM6L device and expand its use across healthcare settings.

Type
Quality Improvement
Information
BJPsych Open , Volume 9 , Supplement S1: Abstracts from the RCPsych International Congress 2023, 10–13 July , July 2023 , pp. S106
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NC
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Footnotes

Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.

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