Cath Lab & Beyond: A Training Program for Beginning Cath Lab Staff

Cath Lab & Beyond faculty: Stacy Intille RN, Nancy Diehl RN, MSN, CNS, Brenda McCulloch RN, MSN, CNS.
A few of the participants in Cath Lab & Beyond.

Brenda McCulloch, RN, MSN, CNS
Sutter Heart Institute, Sutter Medical Center, Sacramento, and Nancy Diehl, RN, MSN, CNS,
Kaiser Permanente Medical Center, Roseville, California

2007 Course

For the upcoming 2007 course, we have reformatted the course content from past years. What was initially a 5-day program is now a 4-day program, with 8 CEs awarded each day. Lectures are updated so that current trends and practices are reflected. The curriculum has been reorganized and a festive evening vendor reception is being added. In addition, organizers are adding an optional cath conference during one of the lunch breaks so that our participants can have an additional opportunity to review films and learn more about the various disorders that bring patients into the cath lab setting.

Cath Lab & Beyond is a great value. The cost of the program is $50 per day for those who work for participating hospitals. For those who work for non-participating hospitals outside of the Sacramento area, the cost is $80 per day. Registration fees include lectures, an extensive syllabus with reference materials and participation in the cath conference, as well as the evening reception, daily continental breakfast and an afternoon snack.

Program Development

Several years ago, a serious need for cath lab education for new staff at Mercy General Hospital was identified. In response, a team comprised of staff, educators, and clinical nurse specialists was established for brainstorming. This group developed the basic curriculum that continues today in the course. The first Cath Lab & Beyond program was considered an experiment to determine if other cath labs in the area had the same need for education experienced by Mercy General. The planning team never considered that years later, the program would still be packing auditoriums with cath lab staff from all over! Originally, Cath Lab & Beyond was designed as a five-day (35-hour) training course for staff members new to the cath lab setting. Starting in 2001, it has been provided once or twice each year. Since the inception of Cath Lab & Beyond, almost 400 cath lab professionals have participated in this program. Faculty who teach in the program are experienced cath lab and cardiovascular staff who work in various hospitals in the greater Sacramento area.

The CEC: Organizing for education
Cath Lab & Beyond has been a component of Sacramento's Continuing Education Consortium (CEC, for several years. The primary goal of the CEC is to offer quality critical care, emergency department, and related education at a reasonable cost through a collaborative effort of expert nurse educators and clinicians. Most of the hospitals in the greater Sacramento area participate in the CEC, including Barton Memorial Hospital, Catholic Healthcare West Greater Sacramento Service Area, Fremont-Rideout Health Group, Kaiser Capital Service Area, Kindred Hospital, Marshall Hospital, Methodist Hospital, Shriners Hospital, Sierra Nevada Memorial, Sutter Auburn Faith Hospital, Sutter-Davis Hospital, Sutter Medical Center, Sutter-Roseville, UCD Medical Center, and Woodland Memorial Hospital.

The CEC is managed by one of the member hospitals for a five-year period of time and then rotated to another member hospital. Currently, Catholic Healthcare West/Mercy's Strategic Learning Development is overseeing the program. Other educational offerings sponsored by the CEC include Critical Care Program, ED Nursing Program, Basic Cardiac Monitoring Course, Intermediate EKG, 12 Lead EKG, Med/Surg Telemetry Course, and EP & Beyond.


Topics covered in Cath Lab & Beyond include cardiovascular anatomy and physiology using heart dissection, review of various cardiovascular disease processes, hemodynamic principles and monitoring, pharmacology review of medications commonly administered in the cath lab, and a detailed overview of various diagnostic, therapeutic, and interventional coronary and peripheral procedures. Hemostasis and vascular closure devices and intra-aortic balloon pumping and are also reviewed. Actual case studies, including films, are used as teaching aids as much as possible.

Looking Back: A sample of past courses

Initially, the complete program content was structured over five days. The course was set up so that participants had the opportunity to sign up for only Day 1 and Day 2 if they wished. This option was marketed to nursing staff who worked outside of the cath lab with patients who are undergoing diagnostic, therapeutic, or interventional procedures, such as in the critical care setting, the cardiovascular interventional unit, or telemetry.

On Day 1, cardiovascular anatomy and physiology were reviewed in-depth with participants beginning the day by forming small groups and learning anatomy as they dissected a beef or pig heart. This has always been one of the most popular activities, even though it follows the continental breakfast! After reviewing basic hemodynamic principles, various cardiovascular disorders that could cause a patient to come to the cath lab were discussed in detail. These disorders include acute coronary syndrome, heart failure, valvular heart disease, cardiomyopathy, and septal defects.

Day 2 included a case study-based review of the medications most commonly administered in the cath lab setting, such as vasodilators, anti-platelets, anti-thrombins, anti-arrhythmics and procedural sedation agents. Following lunch on Day 2, an overview of hemostasis was presented, then the group split into smaller groups. Each group spent time with the various vendors for vascular closure devices marketed at the time. The day closed with a basic review of electrophysiology procedures and pacemaker/ICD device implants. When the program was provided on the campus of one of the hospitals, tours of the cath labs and EP labs were coordinated at various times during breaks and lunch.

Day 3 was devoted to an in-depth review of the various diagnostic and therapeutic procedures commonly performed in cath labs, such as right and left heart catheterization, coronary angiography, left ventricular angiography, pericardiocentesis, temporary pacemaker insertion, and right ventricular biopsy. Indications, techniques, and complications of each procedure were carefully reviewed. A more in-depth review of intra-aortic balloon pumping was provided, focusing on pump set-up and catheter insertion. Hands-on time with the balloon pump was available following the lectures. Vendor support from Arrow International has been used for this section of the program.

Coronary, peripheral, and neurological interventional procedures and emerging technologies were reviewed on Day 4 and 5. Whenever possible, one of the area's high-volume interventionalists spent some time with the group, reviewing cases and answering questions. Additional time was spent with representatives from each of the major vendors who demonstrate their current products. Day 5 ended with Putting It All Together an interactive case study-based review of multiple cath lab complications and emergencies. One year, we were able to provide access to the SimSuite simulator in the Center of Virtual Learning on the campus of UC Davis Medical Center, which was an incredible learning opportunity for the participants.


A major key to the program's success has been the organization, commitment and continuing enthusiasm of the course coordinator and instructors. Nancy Diehl RN, MSN, CNS, Clinical Nurse Specialist from Kaiser Permanente, has been the course coordinator and an instructor from the beginning. Other teaching staff, who are also experienced cardiac and vascular experts, have included Deidre Harris RN, Roberta Stewart RN, Stacy Intille RN, Ellie Vierra RN, MS, Susan Croopnick RN, MSN from Mercy General Hospital; Jane Eymer RN, BSN and Kori Harder RN, MSN, CNS from UC Davis Medical Center, and Mark Switters RN, BSN and Brenda McCulloch RN, MSN, CNS from Sutter Memorial Hospital. Throughout the year, you will find the various instructors searching their respective cath lab archives for great teaching images and collecting treasures from the various vendor representatives to raffle to the participants. Instructors are paid by their respective employer or by the CEC if the instructor is acting as an independent contractor.


Nearly 400 staff members have participated in Cath Lab & Beyond. While students come predominately from the greater Northern California region, we have had many participants from Southern California, Washington, Oregon, Nevada, and from as far away as Montana, Pennsylvania and Toronto, Canada. The courses have ranged in numbers from 20 to 70 participants. The groups have been lively and animated with lots of excellent networking accomplished. One very social group even organized an after-class soiree at a local Chevy's Restaurant.

The Cath Lab & Beyond faculty has been invited by several facilities to take the program on the road and present in various parts of the country. At this time, we have not done so, but do look forward to traveling in the future. Anyone interested in a Cath Lab & Beyond cruise in the Caribbean?

Based on the continued success of Cath Lab & Beyond, a new course called EP & Beyond is currently under development and will preview September 24-27, 2007. Updated information (including registration forms) about Cath Lab & Beyond and EP & Beyond can be found at


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