I have two professional goals in life: to improve nursing practice through education and to create opportunities for nurses to achieve their full potential. Through education nurses can become better patient advocates and achieve better outcomes. Opportunities for nurses to excel include changing practice on their units, getting involved in their professional organizations, and sharing their knowledge with their peers. My new appointment as editor-in-chief of Nursing2009 Critical Care provides me a wonderful opportunity to achieve these goals.

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According to the American Heart Association, we admit almost 1.7 million patients with acute coronary syndromes (ACS) annually. ACS encompasses two patient groups: those who present with either unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) or ST-elevation myocardial infarction (STEMI). About 70% (1.17 million) present with UA/NSTEMI.1 Yet when reviewing data from national ACS registries like CRUSADE (Can Rapid risk stratification of UnStable Angina patients suppress aDverse outcomes with Early implementation of the ACC/AHA guidelines), we're consistently less aggressive in adhering to the ACC/AHA Treatment Guidelines for NSTEMI patients compared to our adherence to the same guidelines for STEMI patients.

Continuous ST segment monitoring can significantly enhance the care we provide to all ACS patients, especially UA/NSTEMI patients. Continuous ST segment monitoring has the potential to detect ischemic changes even when patients are asymptomatic. This strategy can help prevent or at least reduce the size of the infarct. Many of today's cardiac monitors have the capability of continuously monitoring ST segments but this function is very underutilized.

Since February is American Heart Month, I encourage everyone to evaluate your practice regarding ST segment monitoring. Find out if your monitors have ST segment monitoring functions. If they do, then learn how to use them. If they don't, when the time comes to evaluate new equipment make sure that you recommend continuous ST segment monitoring. Visit http://www.americanheart.org to review The AHA Scientific Statement on Practice Standards for Electrocardiographic Monitoring in Hospital Settings. Also, review AACN's practice alert for ST Segment Monitoring at http://www.aacn.org. Both are readily available for use to drive your practice. If you're currently using continuous ST segment monitoring in your unit, double-check that this practice is consistent throughout your hospital on other units that continually monitor cardiac rhythms.

Until the next time: Be healthy, be happy, and be great advocates for your patients!!

Anne Marie Palatnik

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Coordinator of Continuing Education, Clinical Education & Research, Virtua Health, Marlton, N.J. [email protected]

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