Central Monitoring Units: Implementation Strategies, Challenges, and Enablers Impacting Sustainable Operations for Nurse Leaders (A Narrative Review)

Vollständiger Abstract

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Objective: Synthesize existing evidence on the implementation, operation, and sustainability of central monitoring units (CMUs) in US hospitals. Background: Continuous monitoring of vital signs is essential for patient assessment and the early recognition of clinical deterioration. Across many health systems, patients’ vital signs can be monitored from a centralized location, commonly referred to as a CMU. Technological advances have expanded CMU capabilities and improved situational awareness and patient safety, creating new opportunities for nurse leaders to enhance care delivery, workforce efficiency, and system coordination. However, standardized frameworks to guide CMU implementation remain limited. Methods: A narrative review following Arksey and O’Malley’s scoping framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted using PubMed and CINAHL for studies published between 2015 and 2025. Results: Ten studies met the inclusion criteria. Effective practices and strategies included standardized telemetry protocols, structured governance, and trained monitoring staff. Persistent challenges involved alarm fatigue, inconsistent training, and financial and cultural barriers. Sustainability was supported by human-centered design, interdisciplinary collaboration, and continuous quality improvement. Conclusions: CMUs show strong potential to enhance patient safety and workflow efficiency, but evidence-based implementation frameworks are needed to support consistent, scalable adoption across healthcare systems. The synthesis of existing evidence has several implications for nurse leaders.