Table 3.

Percent of nurse responses to competence on physiologic monitors use items organized by subscales and confidence level (N=30).

Item No.	Assessment items by subscale	Percent of nurses (%)
		Confident	Neutral	Not confident	Never used
1. Admit, Discharge, and Transfer Patient
1	Discharge patient from central and beside monitors	87	0	13	0
2	Admit patient to central and bedside monitors	87	3	10	0
3	Transfer patient from central and bedside monitors	53	20	23	4
4	Edit patient information after admission	50	20	23	7
5	Resolve patient information mismatch (e.g., between X2a and bedside monitor, or bedside and central monitors)	33	44	23	0
2. Hardware and Connectivity
6	Connect monitor cables	83	0	17	0
7	Identify monitors’ major hardware components and connectors (SpO2b, NBPc, etc.)	80	3	17	0
8	Report device malfunctions to service personnel	70	3	20	7
9	Identify battery's power status of X2a monitor from display color (green, yellow, or red)	57	13	17	13
10	Clean, sterilize and disinfect monitors and monitors accessories	57	20	17	6
11	Describe the functions of alarm lamps and front panel color indicators (or LEDsd)	17	36	10	37
3. Alarm Management
12	Pause alarms and cancel the pause	93	0	7	0
13	Silence alarms	83	0	10	7
14	Know different types of parameters’ display and the meaning of waves and information in the display (e.g., arrhythmia, SpO2b, Respiration, etc.)	80	10	10	0
15	View all active alarm messages easily	80	3	17	0
16	Change alarm volume easily	80	3	7	10
17	Choose and change the source (e.g., Systolic, Mean, Systolic and Mean) of an alarm appropriately (e.g., pressure alarms source, NBP c, etc.)	77	13	10	0
18	Change alarm limits safely and appropriately	73	10	17	0
19	Change alarm limits easily	73	10	17	0
20	Identify and differentiate the priority (e.g., from crisis to advisory) and meaning of all physiologic alarm messages, based on visual and audible alarm indicators	73	10	17	0
21	Acknowledge and correct alarm messages appropriately	73	17	10	0
22	Identify and differentiate the priority and meaning of technical alarm messages (e.g., Check Equipment), based on visual and audible alarm indicators	70	13	17	0
23	Differentiate the source of each alarm (e.g., HRe Low alarm is from ECGf settings)	70	20	10	0
24	Customize default settings to patient specific	67	13	20	0
25	Troubleshoot common technical alarm messages (e.g., !!Check Patient ID)	57	17	23	3
26	Eliminate redundant alarms when changing default settings (e.g., if STg and STEh are selected, STEh will be redundant alarms)	53	17	27	3
27	Understand the monitor logic behind displaying different types of alarms (e.g., if there is an active ventricular bigeminy alarm, a PVCi > 6/min will NOT be triggered because it is lower in the same priority chain)	53	23	17	7
28	Know when you need to contact service personnel to correct technical alarms vs. when you need to troubleshoot the problem	50	17	23	10
29	Extend alarm pause time	30	17	23	30
30	Differentiate the behaviors of latching (alarm automatically will turn off when the condition no longer exists) vs. non-latching alarms (require nurse to turn alarm off even if the condition no longer exists)	17	33	10	40
4. Appropriate Monitoring
31	Place electrodes appropriately	97	0	3	0
32	Understand best practices in electrode placement (frequency of changing electrodes, skin preparation)	97	0	3	0
33	Change the NBPc measurement interval	97	0	3	0
34	Select the appropriate NBPc measurement modes (manual, auto, sequence, stat)	90	3	7	0
35	Store and send the 12-lead ECGf to the central monitor	90	3	7	0
36	Zero the pressure transducer	90	0	7	3
37	Put monitor into Standby mode and resume from Standby monitoring	90	7	3	0
38	Select appropriate invasive pressure label for monitoring (e.g., ABPj, ICPk, PAPl, Aom)	87	6	7	0
39	Change the size of a waveform	83	0	17	0
40	Select optimal SpO2b measurement site	83	4	13	0
41	Recognize elements and purpose of using monitors’ Screen Keys: (1) The four permanent keys (Silence, Pause Alarms, Main Setup, Main Screen), (2) smart keys, and (3) pop-up keys	80	13	7	0
42	Pick best primary and secondary leads for paced and non-paced patients	77	3	17	3
43	Navigate the different monitors' screens easily	77	6	17	0
44	Check beats annotation and relearn arrhythmia analysis	73	10	10	7
45	Adjust speed of different kinds of waves	67	6	20	7
56	Pick the appropriate lead for STg monitoring	67	16	7	10
47	Freeze and unfreeze waves	63	10	20	7
48	Recognize when specific monitoring is needed for specific patient cases (e.g., STg-Segment monitoring, QTn monitoring)	63	14	20	3
49	Recognize patient cases when specific monitoring is NOT recommended or clinically insignificant (e.g., in cases of setting STg or QTn monitoring)	63	21	13	3
50	Review trended patient data using screen trends	60	16	7	17
51	Explain the information displayed in trend windows	60	10	10	20
52	Use shortcuts to navigate monitor screens and keys efficiently (e.g., Select Quick Admit Smart Key to quickly admit a patient)	43	27	13	17
53	Differentiate/print patient reports available within the monitor	40	20	23	17
54	Temporarily disable/re-enable monitor touchscreen operation	33	24	23	20
5. Advanced Functions
55	View hemodynamic, oxygenation, and ventilation calculations	50	13	17	20
56	Perform parameters calculations	37	26	10	27
57	Access/use the drug calculator from the monitor	20	20	17	43
58	Manually enter some data into the monitor (e.g., lab results)	7	29	17	47
59	Use sepsis protocol and its guidelines that are within the monitor	3	21	13	63

^aX2: is the transport monitor. ^bSpO2: peripheral capillary oxygen saturation. ^cNBP: noninvasive blood pressure. ^dLED: light-emitting diode. ^eHR: heart rate. ^fECG: electrocardiogram. ^gST: ST segment in the electrocardiogram. ^hSTE: ST elevation. ⁱPVC: premature ventricular contraction. ^jABP: arterial blood pressure. ^kICP: intracranial pressure. ^lPAP: pulmonary artery pressure. ^mAo: aortic pressure. ⁿQT: QT segment in the electrocardiogram.