ICM Implantation and Remote Follow-Up Management by Trained Nurses in Italian Hospitals: Current Practice and Nurse Feedback.

Abstract

Aims: This project aimed to evaluate current practices of trained nurses performing implantable cardiac monitor (ICM) implantations and remote follow-ups in Italy, assessing hospital protocols and nurses' perceptions.

Methods: An anonymous survey was conducted among 163 trained nurses across 75 Italian hospitals, focusing on their ICM implantation and remote monitoring practices. Data collected included hospital characteristics and protocols, barriers to implementation, and nurses' feedback on their experiences.

Results: Of the 112 respondents (69% response rate), 60% reported that nurses in their hospitals are authorized to perform ICM implantations, and 70% said that they can manage all remote monitoring tasks. Thirty-three (29%) nurses manage all aspects of ICM patient care, including implantation, programming, enrollment in remote monitoring, training, data review, and follow-up. Fifty-five percent of nurses perform a part of ICM implants outside the EP/Cath lab, and for 31%, this is the primary location. 84% of implanter nurses achieved autonomy after < 10 supervised implants. More than 90% of implanter nurses consider ICM implantation rewarding and 96% find it safe and easy with the provided kit. However, only 33% and 17% of nurses had written protocols at their hospital, to guide ICM implantation and remote monitoring, respectively.

Conclusions: Nurse-led ICM implantation and remote follow-up are becoming established practices in Italy, with many nurses operating independently. Despite this progress, the absence of standard operating procedures limits the widespread adoption of these practices. Clear national and international protocols are essential to enhance nurse training, ensure safe practices, and ultimately improve patient care in ICM management.