An evaluation of the development of nursing service systems in assisting patients with the use of cardiac event recorder for outpatients at a university hospital

Background: Patients with suspected cardiac arrhythmias frequently present to healthcare facilities after symptomatic episodes have resolved, making timely diagnosis challenging. Portable cardiac event recorders enable capturing abnormal heart rhythms during symptomatic episodes in daily life. However, optimal utilization requires effective patient education and comprehensive nursing support systems. This study aimed to evaluate the development and effectiveness of a nursing service system in assisting outpatients with portable cardiac event recorder use, utilizing the CIPP (Context, Input, Process, Product) evaluation model by Stufflebeam.

Methods: A descriptive research design was employed with 84 outpatients suspected of having cardiac arrhythmias. Data collection instruments included:

(1) personal information questionnaire,

(2) self-efficacy questionnaire regarding device usage,

(3) social support questionnaire for family assistance, and

(4) outcome evaluation form for device utilization. The nursing service system incorporated structured procedural adjustments, enhanced nurse education regarding patient instruction, and scheduled follow-up contact every seven days for one month. Descriptive statistics were used for data analysis.

Results: Participant demographics revealed the majority were female with a mean age of 53.26 years. Approximately 74.80% had never previously used the device, while 47.60% required family member assistance for proper operation. Notably, 74.10% of participants perceived themselves as capable of using the device independently after the intervention. Common operational difficulties included pressing the recording button multiple times (23.80%) and forgetting usage procedures (17.90%). The success rate of electrocardiogram transmission improved significantly from 87.00% during the first week to 96.00% by the fourth week of follow-up.

Conclusions: A comprehensive, systematically developed nursing service system integrating structured patient education, consistent follow-up contact, and interdisciplinary collaboration effectively supports outpatients in utilizing portable cardiac event recorders safely and efficiently. These findings underscore the critical importance of systematic nursing interventions in enhancing patient competence and device utilization outcomes. This model provides a sustainable framework for best practice implementation in outpatient cardiac care settings.