What Do You Think?

Multiple new and ongoing questions from readers. Your responses are welcome! Answer or pose a question at cathlabdigest@aol.com

Inside the Cath Lab What do other labs do about hats, masks, etc., for setting up tables for cath/PTCA procedures and pacer/defib procedures? Do they wear gowns when setting up device tables? Does the staff wear hats/caps and masks when doing cath/PTCA procedures? Name withheld by request Cc: cathlabdigest@aol.com Career Ladder At our institution (Genesis Medical Center in Davenport, IA), we are attempting to institute a career ladder for RT(R)s. Can any lab give input as to how they established their ladder and how it works? Thank you! Jena Moore, RT(R), CVIT, BA Email: mooreje@genesishealth.com Cc: cathlabdigest@aol.com Transducers What is your standard procedure for changing transducers? Thank you! Ronald Williams Email: ronald.williams@tenethealth.com Cc: cathlabdigest@aol.com Response: Transducers are changed for every case. Blood can back up into the transducer, so for the patients’ safety, we change it for every case. Name withheld by request Cc: cathlabdigest@aol.com Peer Review for RNs I’m looking for a “Cath Lab Peer Review” for nursing. Is there such a review existing in any facility? We will be starting our Joint Venture in October. Our manager would like a new style in place for peer review. Kathleen Nugent, RN Email: nugentka@sbcglobal.net Cc: cathlabdigest@aol.com Monitoring Alarms I would like to know if other labs silence the monitoring alarms in their labs. With someone constantly observing the patient and a monitor tech watching, we silence our alarms due to the constant activation of the alarm when working in the heart. I have contacted several labs in our area and found that they do the same. Is this a common practice in other cath labs? Binnie Howard, RN, BSN, Director, Regional Heart Institute Email: Binnie.Howard@st-marys.org Cc: cathlabdigest@aol.com Patients Without Accompanying Family or Friend I work at a university-based teaching facility in the cath lab. Our elective heart cath patients are called before the procedure or receive written instructions about the care post procedure. Specifically, they are told to make sure that someone else will be able to drive them home after the procedure and that they should have someone stay with them the night after the procedure. This is because of the sedation given and the arterial puncture performed. We have recently started to have patients arrive without a driver to take them home and/or someone to stay with them. Most of the time when nursing informs the MD that the patient doesn’t have a ride home or will be home alone, the procedure will be rescheduled. But recently, we have gone ahead with the elective procedure, extended the bedrest and then sent the patient home by cab, or to a nearby hotel by cab paid for by the hospital. Our written discharge instructions clearly state that the patient should not drive for 24 hours post procedure and how to manage a bleed from the puncture site. Nursing is getting uncomfortable, from a patient safety standpoint, sending these patients out of the hospital in a cab and to a hotel alone. How do other institutions manage this predicament? Anonymous Email: cathlabdigest@aol.com

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