Cath Lab Digest - February 2008 - (Page 21)

FEBRUARY continued from page 1 2008 SPOTLIGHT 21 Bay Regional Medical Center • 8 radiologic technologists; • 2.6 cardiac care associates (CCAs) • 3 electrophysiology (EP) RNs and 1 EP RT. Our institution currently has 4 rooms and in March 2008 will open a fifth room. Two rooms are primarily interventional cardiology and EP procedures. Interventional radiology and neuroradiologists use our rooms as well. What types of procedures are performed at your facility? We peform diagnostic and interventional cardiology, peripheral interventions (renal, carotid, aorto run-off, aneurysms, etc.), EP procedures (implantable cardioverter-defibrillator [ICD], pacemaker), intra-arterial tissue plasminogen activator (tPA) and stroke scales by certified practitioners. What procedures do you perform on an outpatient basis? Diagnostic caths, routine angiograms and pacemaker placement are routinely done on an outpatient basis. Has your cath lab expanded in size and patient volume? We are adding a fifth room in March of this year. Over the last 6 months, we have moved all cardiac procedures to one floor. Previously, we were scattered over 4 or 5 different floors. Bay Regional Medical Center recently opened a $54 million “south tower” where a large percentage of the second floor is dedicated to cardiology. What ages do you serve? Age 16 and up. How and when did you begin performing peripheral procedures? Cardiology began doing peripheral procedures in 2003. Our vascular surgeons began in 1999 and interventional radiology has been performing peripheral procedures ever since the hospital angiography suite first opened in 1977. As you noted, different disciplines perform peripheral procedures in the same area? Yes, vascular surgeons, interventional radiology and interventional cardiology all share space. What specific equipment is instituted and/or dedicated to peripheral procedures? We have a Philips FD 20/10 flat panel projector (Bothell, WA) and can do multi-angle/bi-plane shots with just one injection. Does your staff perform antegrade puncture for peripheral procedures? Trained nurses, radiology technologists and RCISs perform the vast majority of arterial punctures, but only a few have conducted an antegrade puncture for peripheral cases. Have you had any cath lab-related complications in the past year requiring emergent cardiac surgery? Yes, but these are very, very rare and usually come in as emergencies. These are mostly cardiac dissections or perforations that continue to deteriorate. How does your cath lab compete for patients? Has your institution formed an alliance with others in your area? Bay Regional Medical Center manages a large family practice in the West Branch area of Michigan (the northwest part of state), which provides a large referral base within a 45-mile radius. In addition, as we noted earlier, the department has been opened to all trained specialties. By bringing the specialties together, we increase our patient population by virtue of proximity. The goal of bringing the specialties together was to improve the overall quality of care and safety for this patient population. What percentage of your patients are female? Approximately 40% of our patients are female. What percentage of your diagnostic cath patients go on to have an intervention? Approximately 25% of all diagnostic patients go on to have some sort of immediate or staged intervention. What is standard of care (ambulation and discharge) for those diagnostic Left to right: Brenda Harris RN, Chris Burnside RT, Dr. Nilofar Islam and Carol Bejarano RN. CVCU staff. Back, left to right: Susan Stoffel RN, RCIS, Kelly Link RN, Cathy Kozak CCA and Debbie Carter LPN. Front: Anne Reeder, Nursing Clerk. Cath lab: John Traxler RT and Dr. Eric Sweterlisch. patients who do not go on to an intervention? Diagnostic patients generally receive a vessel closure device and are ambulated 1-2 hours post procedure. If stable, they are discharged immediately following ambulation (3 hours on average). Who manages your cath lab? Willa Rousseau, BSN, is the Director of Cardiology Services, Scott Fylling, RCIS, is Cath Lab Manager of Operations. Who manages the training for your cath lab staff? The clinical educator within the cath lab, Susan Stoffel, RN, RCIS. Do you have cross training? Who scrubs, circulates and monitors? All staff is cross-trained to scrub, but only RNs or RCISs will circulate. Monitors can be RN, CVT, RCIS or RT, if they have received hemodynamic assessment certification. All possess advanced cardiac life support (ACLS)certification. Does an RT have to be present in the room for all fluoroscopic procedures? No. An RT presence is preferred but not mandatory. The fluoro is

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

Cath Lab Digest - February 2008 Bay Regional Medical Center ENDEAVOR IV: A Zotarolimus-Eluting Stent Versus a Paclitaxel-Eluting Stent in a Randomized Clinical Trial A 3D CT Vessel “Roadmap” Over Live Fluoroscopy for Chronic Total Occlusions Contents Clinical Editor’s Corner An Evaluation of Cath Lab Turnaround Time Commentary: An Evaluation of Cath Lab Turnaround Time Excerpts from Chapter 19. STEMI Interventions – Future Perspectives The Potential Clinical Utility of Intravascular Ultrasound Guidance in Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents The Ten-Minute Interview with…Debbie Charlton, RN The Society of Invasive Cardiovascular Professionals (SICP) at Transcatheter Cardiovascular Therapeutics (TCT) 2007 The Cath Lab is a Business: Do You Have the Knowledge to Stay Afloat? Incidence and Predictors of Vascular Complications after Invasive Coronary Procedures: A Prospective Analysis Ask the Clinical Instructor: A Q&A Column for those New to the Cath Lab Volunteer Survey SICP* Section Meetings Calendar What Do You Think? CEU Education Center Clinical & Industry News Classifieds Advertisers Index

Cath Lab Digest - February 2008

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