Bedside electrocardiographic assessment.
Excellence in bedside monitoring is achievable when attention to detail is practiced. The cardiovascular nurse must choose a monitoring lead to best identify dysrhythmias and a lead to best identify myocardial ischemia with ST segment monitoring. Multilead viewing is preferrable but not possible with most current systems, which provide observation of one precordial lead at a time. Above all, the nurse must first place the leads correctly on the patient's chest. A quality assurance approach that involves all levels of nursing can help to integrate current research into practice. Nursing practice can be improved when changes are linked to science.