Prolonged QTc and Prevention of Torsades de Pointes Clinical Pathway — Inpatient
Prolonged QTc and Prevention of Torsades de Pointes Clinical Pathway — Inpatient
Goals
- Prevent torsades de pointes (TdP) and death from TdP in inpatients at risk of QT prolongation
- Facilitate prompt identification and management of inpatients with prolonged QTc interval on ECG
Metrics
Outcome
- Percent of inpatients with prolonged QTc ≥ 470-499 ms who develop ‘unstable ventricular arrhythmia / Torsades de pointes (TdP) or death from TdP’
- Percent of inpatients with critically prolonged QTc (QTc ≥ 500 ms) who develop ‘unstable ventricular arrhythmia / TdP or death from TdP’
- Percent of inpatients with risk factors who develop critically prolonged QTc (QTc ≥ 500 ms)
Process
- Number of ECGs obtained in inpatients secondary to risk factors
- EP / cardiology consults secondary to prolonged QTc (QTc ≥ 470-499 ms and QTc ≥ 500 ms)
- Time from performance of ECG (during inpatient stay) to recognition and confirmation (finalized reading) of critically prolonged QTc (QTc ≥ 500 ms)
- Percent of inpatients with critically prolonged QTc (QTc ≥ 500 ms) in whom 'Prolonged QT Interval' was added to problem list during inpatient stay
- Time from performance of ECG with critically prolonged QTc (QTc ≥ 500 ms) to addition of ‘Prolonged QT Interval’ to problem list
- Percent of non-cardiac inpatients placed on ‘telemetry / supplemental arrhythmia monitoring’ per month/year for critically prolonged QTc (QTc ≥ 500 ms); total number of days on telemetry / location