December 2008 Society of Invasive Cardiovascular Professionals (SICP) News

SICP Chapter Spotlight

The SICP has several established and developing chapters across the country. Chapters offer networking opportunities and grassroots advocacy opportunities for current issues in the invasive cardiovascular profession. They also offer a great way to keep members up-to-date on ongoing membership developments. Belonging to a chapter is an excellent way to become more involved in your professional Society, advocating and promoting the invasive cardiovascular profession. SICP will begin a series of Chapter Spotlights to inform our members of each chapter’s ongoing activities and accomplishments. The Keystone Chapter For SICP members in the southeast Pennsylvania area of Lancaster, PA. When was the Keystone Chapter established? December 2005. What facility is involved in this chapter? Lancaster General Hospital. How many members does the chapter currently have? 90. What is the focus of the Keystone Chapter? The key focus of the Keystone Chapter is on educating the RCIS professional and legislative initiatives to further advance the RCIS credential. What challenges are you currently facing? One of our main challenges is trying to get individuals from surrounding institutions to be part of the leadership of the Keystone Chapter. What are the chapter’s accomplishments? We have hosted five dinner CEU meetings, and one RCIS review course. We set up a meeting with our state representative to discuss the process for furthering the credential’s recognition in Pennsylvania. What are your strengths as a chapter? The Keystone Chapter has dedicated leadership with a vision for the RCIS profession. The chapter strongly believes that the RCIS should be the “credential of choice” in the cardiac cath lab and all who work in the invasive labs should hold this credential. What are your chapter goals? We are working for possible licensure of the RCIS by the state of Pennsylvania. What would you like the public to know about the RCIS profession? The public needs to know what an RCIS is and that we have an in-depth knowledge of invasive cardiovascular procedures. The public is most familiar with nursing and we need more public education about our profession. What can SICP do for our members? The national SICP can communicate to the members what the organization is doing on a national level, and help to educate the public about our profession. Has your chapter hosted the SICP’s Signature RCIS Review Course? We have not yet hosted a signature course; however, we did hold our own one-day review course and had an excellent turnout. How many of your chapter members hold the RCIS designation? Sixty percent of our members hold the RCIS credential. Most of the non-credentialed members are students and are waiting to take the exam. Who is your chapter’s Advocacy Committee representative? Mark Koch, RCIS, is our advocacy committee representative. ________________________________

High Point Regional Health System in North Carolina to Host SICP Signature Review Course

The Society of Invasive Cardiovascular Professionals offers professionals in the invasive cardiovascular field educational opportunities that benefit both their patients and facility. SICP administers several review courses around the country each year, often partnering with other cardiovascular conferences. Individual medical facilities can approach the SICP to conduct a review course. They have the option of having this course strictly for their staff or opening the course up to neighboring facilities as well. Angie Boyer, the Cardiac Catheterization Supervisor at High Point Regional Health System located in High Point, North Carolina, approached SICP to host a review course at their facility in August 2008. The RCIS credential is not required by their facility, but they wanted a refresher course to update their staff on new and pertinent information in the field, while preparing those staff that plan to take the RCIS exam. The facility is encouraging its staff to become credentialed. Several of HPRHS’s staff attended the TCT meeting in 2007, where they attended the SICP’s Signature Review Course. They found the content to be extremely helpful, especially to cath lab nurses who did not have prior education or training. Boyer began planning with her facility in August 2008 to host a review course to educate her entire staff. High Point Regional Health System decided on a one-day review course, to be held February 7, 2009. They are opening this course up to neighboring facilities, which allows for twenty additional attendees. Abbott Vascular is sponsoring the course through a grant, assisting in covering the cost for this educational opportunity. Continuing education is vital in the medical profession to ensure patients receive proper medical treatment. Boyer commented, “It concerns me that there are Community Colleges in NC that will teach Vascular/ Cardiovascular courses to the general public without any previous medical training.” If you would like to attend the High Point Review course, please fill out a registration form at sicp.com and return to SICP. For questions, email meetings@sicp.com or call (919) 861-4546. ________________________________

Ask the SICP!

By Kenneth A. Gorski, RN, RCIS, FSICP Chairman, SICP Professional Standards Committee I’m trying to find information on patient care techs accessing an arterial line to obtain a blood sample for ACTs. The techs practice in a post-interventional unit. Are you aware of practices in other facilities, standards or state laws that would speak to this practice issue? I am unaware of specific standards/state laws specifically addressing this issue. The Society of Invasive Cardiovascular Professionals sets standards of practice directly related to cath and EP laboratories. Unfortunately, we (SICP) have concentrated on the procedural and not the post procedure practices. However, I can offer some references that may be of help: Unless specifically forbidden by hospital guidelines, accessing an arterial sheath would be considered a non-critical task. A policy/procedure can be written allowing this to be delegated by a licensed personnel (i.e., physician or recovery area RN), and an annual competency/checklist can be put in place for the employee’s file. Dr. Morton Kern addressed the scope of practice in a Cath Lab Digest editorial, available online at www.cathlabdigest.com/article/6342. (See question below.) Regarding the scope of practice in the cath lab: are there limits as to what cath lab staff should do? From a Cath Lab Digest editorial by Dr. Morton Kern in October 2006: “Nurse/tech duty requirements can be viewed as tasks within the three stages of the cath experience: 1. Pre-procedure setup and preparation; 2. Critical procedures (the angiogram, hemodynamic study and percutaneous intervention); 3. Post-procedure care (including access site management). “I believe the scope of practice in any lab can be divided into tasks performed by the nurse/tech without supervision, tasks performed with remote supervision (e.g., vascular closure devices), tasks with direct supervision (e.g., critical procedures such as seating an angiographic catheter) and tasks which should be performed only by physicians (e.g., complex devices).” Dr. Kern’s complete editorial is available online at: https://www.cathlabdigest.com/article/6342 The SICP Scope of Practice for the Invasive Cardiovascular Professional states: “Personnel should not assume responsibilities for which they are not adequately prepared. It is the obligation of the employing institution to validate an employee’s credentials, preparation and knowledge base for which he/she is hired to assume.” https://www.sicp.com/PDF/Scope_%20of_%20practice.pdf Could you direct me to any reference regarding universal protocol in the cardiac cath lab? One question in particular is in regards to “time out.’ If the arms are tucked and the field draped, to check an armband would compromise sterility. Any information/suggestions you could provide would be appreciated. Patient identification begins prior to the patient coming into the room. Two unique identifiers are to be used. At my institution, our policy is to have the patient state their full name and date of birth, then we verify the medical record number on the wrist band. This is to be completed PRIOR to the patient being taken into the procedure rooms (medical emergencies are exceptions) and documented according to your hospital policy. For the final time out, the team leader should verbalize the medical record number along with the other info. The "time out" is verbal/active; with the exception of emergencies, the patient is awake and acknowledges the team prior to sedation and local to the site. For cardiac catheterizations, a sterile field is maintained for the procedure table and around the insertion site. However, for a variety of imaging angles, it is a requirement to reposition the patient’s arms (i.e., lifting them above the head for lateral views). For this reason, many institutions regard cath labs as "clean procedure areas," not a sterile OR environment. There is some conflict within the literature. The most recent Infection Control Guidelines were published in 2006 by the Society for Cardiovascular Angiography & Interventions (SCAI) and can be found at this link: https://www.scai.org/PDF/ ID%20guidelines.pdf

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