Cath Lab Digest - January 2008 - (Page 18)

18 SPOTLIGHT JANUARY 2008 Left to right: Sonya Burke, RN, Kathryn Partin, RT(R), Misty Mozer, RT(R), Ruth Johnson, RN, and Suzanne Burke, RN. Left to right: Kelly Kinley, RT(R), Donna Carroll, RN, Kari Forsyth, RN, Susan Folsom, RN, and Stuart Henderson, RT(R). bleeding policy is based on protocols and guidelines for the staff which includes notification of the physician at various points throughout the protocol. This protocol was recently revised by the physician board to manage anti-coagulation therapies. How is inventory managed at your cath lab? Who handles the purchasing of equipment and supplies? An inventory control buyer manages our inventory. She tracks usage and re-ordering of supplies according to par levels. Purchasing and the cath lab supply team meet monthly to discuss new supplies and slowmoving supplies. The cath lab director takes care of capital equipment, which is submitted in the budget. Has your cath lab recently expanded in size and patient volume, or will it be doing so in the near future? Our heart institute is fortunate in that our volumes continue to increase. As a result, we have received approval to reconfigure our eighth cath lab as a combination EP/cath lab to improve scheduling capabilities and lab utilization for our physicians. Is your lab involved in clinical research? As a community-based hospital, our cardiac research has expanded significantly as a result of the Lexington Cardiac Research Foundation, established in 2006. We have full-time interventional cardiology research RNs who facilitate the process along with our physicians and staff. Some of the recent studies we have participated in include: • The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) • TAXUS V: Assessing the safety and efficacy of a slow-release formulation paclitaxel-eluting coronary stent system in reducing restenosis in de novo lesions 10–46 mm in length and 2.25–4.0 mm in diameter. • Lower Extremity Atherosclerotic Plaque Excision (LEAP, looking at the SilverHawk Plaque Excision System by FoxHollow Technologies, Inc.) • The second phase of “Carotid Rx Acculink/Rx Accunet Postapproval Trial to Uncover Unanticipated or Rare Events” (CAPTURE-2) • IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE IT) • Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY, looking at bivalirudin) • SPIRIT IV: Continued evaluation of the safety and efficacy of Abbott’s Xience V everolimuseluting coronary stent system for the treatment of coronary artery disease in a more complex patient population. • An evaluation of the Stereotaxis Navigation system. Have you had any cath lab-related complications in the past year requiring emergent cardiac surgery? Our emergent cath lab to coronary artery bypass surgery rate is 0.4%. What other modalities do you use to verify stenosis? We use IVUS and angiography to verify stenosis. Our physicians use a FloWire Doppler guide wire (Volcano Therapeutics). What measures has your cath lab implemented in order to cut or contain cost? We require all balloons and stents to be on consignment from our vendors. We also have a cath lab supply team that meets monthly to evaluate requests for new items and changes or decline utilization of supplies. The team also evaluates and reports overall utilization in inventory to the corporate supply team. What type of quality control (QC)/quality assurance (QA) measures are practiced in your cath lab? Quality control/assurance is an ongoing process. Our facility participates in National Registry for Myocardial Infarctions (NRMI), American College of Cardiology National Cardiovascular Data Registry (ACC-NCDR), Centers for Medicare and Medicaid Services (CMS) database, and various others. Within the department we monitor processes that range from daily equipment checks to the multi-functional teams that monitor our processes for door-to-balloon times for acute myocardial infarctions. Our internal QA indicators evaluate conscious sedation practice and patient outcomes, with recovery scores on every case where the patient received sedation. We also accumulate data on service satisfaction with day-after-service callbacks and survey cards sent to the patient’s home if we are unable to speak with them by phone. The cath lab’s education team continuously works on improving the orientation process from the orientee’s perspective by including input from employees who completed orientation in the last year. How does your cath lab compete for patients? Has your institution formed an alliance with others in the area? We are in a very competitive market for cardiac services. Other hospitals in our area are acquiring smaller hospitals to maintain volume. Central Baptist Hospital (CBH) has the largest cardiac program in a fivehospital system located in Kentucky. As a tertiary hospital, CBH has maintained its competitive edge with an ongoing focus to strengthen and enhance physician relationships and provide the highest standards for quality care. Our 15-member heart and vascular board works cooperatively to develop strategic initiatives for our program. This board has been extremely effective in facilitating expansion of our vascular program, women’s heart health initiatives, establishment of a cardiac research foundation and enhancing physician’s communication and elevating awareness of CMS, ACC and Society of Thoracic Surgeons (STS) quality-of-care initiatives. How are new employees oriented and trained at your facility? What licensure is required for all professionals who work in your lab? New employees complete a 2-week general hospital orientation before starting in their assigned area. Each

Table of Contents Feed for the Digital Edition of Cath Lab Digest - January 2008

Cath Lab Digest - January 2008 Central Baptist Hospital Contrast Media Use in High-Risk Patients An Ergonomic Survey of Cath Lab Repetitive Stress Injuries Contents Clinical Editor’s Corner Takotsubo Cardiomyopathy, a.k.a., Transient Left Ventricular Apical Ballooning Syndrome: An Acute Coronary Syndrome Imposter Searching for the Key to D2B STEMI Intervention News STEMI Interventions: Commentary The Massachusetts Stent Study The Value of Educating Staff Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab SICP* Chapter Updates The Society of Invasive Cardiovascular Professionals Holds an RCIS Review Course at New Cardiovascular Horizons 18:20 To Denver — One Student’s First Clinical Experience CEU Education Center Meetings Calendar What Do You Think? Clinical & Industry News Classifieds The Ten-Minute Interview with…Heather Vardon, RN Advertisers Index

Cath Lab Digest - January 2008

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