Cath Lab Digest

We do not currently have any staff members with less than one year of cath lab experience. Our staff has a varied background, including ICU, ED, telemetry, OR, dialysis and obstetrics. A current Colorado or compact state licensure is required of all our RNs and all cardiovascular technologists are required to be RCIS-certified within 18 months of hire.

What continuing education opportunities are provided to staff members? 

We have many company representatives who provide educational in-services carrying CEU credits. We met our 2011 goal of sponsoring a two-day review course and exam for the CVRN certification. We will be hosting a registered cardiac electrophysiology specialist (RCES) review course at Medical Center of the Rockies on April 12-13, 2012, which will be the first time a course like this has been offered west of the Mississippi. The staff is encouraged to participate in both in-house and outside educational opportunities.

How do you handle vendor visits to your lab?

Vendors are offered scheduling once a quarter. They may provide in-services in our staff lounge, but must be invited to observe in our cath lab rooms by the physician. 

All vendors much check in and we use the services of Reptrax. 

How is staff competency evaluated?

We have several annual house-wide competencies that specifically meet the regulatory needs of the hospital. We also have unit-specific competencies. Our 2011 unit-specific competencies included rotablations, the Impella device, FFR, IVUS, methohemoglobinemia, radial artery catheterizations, and our new acute MI protocol. In 2012, we have had the following competencies: adenosine in the cath lab, pseudo-aneurysms and thrombin injections, CTOs, amd circulating within the electrophysiology lab.

Does your lab have a clinical ladder? 

We do not currently incorporate a clinical ladder in our facility.

Does your lab utilize any relaxation techniques for patients?

We provide music for our patients to listen to during a cath procedure. In the non-invasive areas, such as infusions, we provide our patients with magazines and TVs.

How does your lab handle call times for staff members?

Our lab hours are Monday to Friday, 06:00 to 16:30. The call team consists of four staff members with a 30-minute response time to either hospital. We cover call 365 days a year. Staff members sign up for nights and weekends a couple of weeks ahead of the new schedule. The average requirement for call is about one night of call per week and one weekend every five weeks. There is not an attending cardiologist required to be on site but the 30-minute response time remains in effect.

Do you have flex-time or multiple shifts?

We have 10-hour shifts with some staff flexing in 6-hour shifts during our busiest hours. 

The Pre/Post unit is open from 5:30 am to 19:00,with 8- and 12-hour shifts. We have five different shifts flexing in/out throughout the day, maintaining a 2:1 patient-to-nurse ratio. 

Has your lab undergone a Joint Commission or accrediting agency inspection in the past three years?

Yes, our lab underwent a Joint Commission inspection in 2010. Our lab did not receive any recommendations at this inspection. Our advice to others is to diligently work to follow the Joint Commission guidelines and to practice mock inspections to see where you might need to make corrections.

How does your lab communicate information to staff and physicians to stay organized and on top of change?

We have monthly mandatory staff meetings, e-mails, bulletin boards, “Over the Wire”, a weekly newsletter for the cath lab, and have just added a new wiki space (our own cath lab website). Monthly in-services are scheduled by our representatives to keep us abreast of changes in products.

Where is your cath lab located in relation to the operating room (OR) and the emergency department?

All of our cath labs are right next door to the OR, with the exception of our hybrid lab. The emergency department is just down the hall from the cath lab at Poudre Valley Hospital and is one level down from the cath lab at Medical Center of the Rockies.

How do you see your cath lab changing over the next few years?

Our lab is expanding on the services we will be providing to our patients. The new services for 2012 will be same-day discharge for PCI, cryoablations, TAVR, and CTO procedures. Our facility is also merging with University of Colorado Hospital and potentially, Memorial Hospital, to provide a broader range of services to a greater population.

What is unique about your cath lab and staff?

Our lab is unique in the fact that our staff works and covers call for two separate hospitals. MCR and PVH are considered sister facilities, under the heading of Poudre Valley Health Systems, but both facilities operate as its own separate entity. Our lab is also unique in the fact that the majority of our staff is RNs and we are all cross-trained to do all tasks within the lab. 

Every fall, our lab sponsors a “Duck Race.” All of the money raised is then donated to the hospital foundation and distributed to employees in need.

Is there a problem or challenge your lab has faced?