At a large midwestem healthcare organization, cardiac telemetry monitoring orders are not aligned with clinical guidelines developed by the American Heart Association (AHA). A nurse-driven protocol, based on AHA guidelines, to manage cardiac telemetry orders may reduce telemetry usage. Donabedian\u27 s quality improvement framework of strnch1re-process-outcomes was utilized as the theoretical framework for this project, with the purpose to reduce telemetry days within 30 days on a selected acute care unit utilizing AHA guidelines. Project objectives included developing an assessment tool based on AHA guidelines, educating pe1iinent stakeholders on the nurse assessment tool, and implementation of the tool on the chosen acute care unit for 30 days. Pre- and post-implementation data that included the date telemetry was started and stopped were obtained from the organization\u27s Central Monitoring Unit (CMU). Upon commencement of the implementation, submitted assessment tools were reviewed for completion accuracy and paired with post-implementation data provided by the CMU resulting in 14 patients with complete data for analysis. Data analysis indicates a potential 30.5% decrease in telemetry monitored days and a potential savings of over $2 million annually to the identified healthcare organization