Allied Professionals Community of Practice

We are finding that we have several patients with a single spike in impedance, that comes back down to normal. What are you doing with those types of patients? With all of the ongoing advisories, how are you managing "advisory fatigue," so that in 6 months, a patient whose device has had normal impedances, who has increased impedance above the 150 ohm mark, does not get missed?

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Janet Powell MSN, FNP
Nurse Practitioner
Ballad Health CVA Heart Institute
Kingsport TN
(423) 230-5000
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HI Janet, you raise an interesting point. The advisory recommends using
the "most recent 28 day average impedance" to determine risk category.
Since mathematically calculating the average is certainly not practical,
one way to estimate this is by using the impedance trend graph.

MURJ developed an advisory tool that displays all patients in the advisory
with their most recent lead measurements as well as their most recent trend
graphs. This visual is very helpful in managing these advisory patients,
and the report can be run periodically to quickly assess for any patients
who are moving into a higher risk category.

There is also the Latitude alert for high impedance which should trigger a
transmission and an audible alert. The Emory team is making it a habit to
test the beeper in clinic for all BSX patients and making sure it is turned
on.

Hope this helps,

Sallie

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Sallie Gustafson RN, BSN, CCDS

Director Medical Affairs

MURJ, INC.

831.621.2349 | murj.com

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