New Cardiac Ablation Technology Trends
- Fri, 12/16/11 - 10:58am
- 0 Comments
- 1527 reads
By: Matthew Dare, CEPS, Research and Technology Coordinator, Texas Cardiac Arrhythmia Institute
One of the things I have always loved about EP is the myriad of cutting-edge technologies we use on a daily basis. With technologies such as integrated control and video systems, 3D mapping, remote navigation, telepresence and a dizzying array of ablation technologies that include radiofrequency, cryo, and lasers, a modern EP lab resembles something closer to a video game or mission control at NASA than an operating room. And as a member of a generation raised on video games, I feel right at home.
We didn't get to this point of high-tech integration overnight — it has taken years and years of advances to get us to where we are now. With that thought in mind, I'd like to look back on the advances of this past year and some promising pieces of technology we might see in the coming year:
Diagnostic Radiation Risk and Liability in the EP Lab
- Fri, 10/28/11 - 9:31am
- 0 Comments
- 993 reads
By: Chris Atherton, RN, BSN, MPA
On August 24, 2011, the Joint Commission issued a Sentinel Event Alert concerning radiation risks of diagnostic imaging. The Alert described the issues surrounding high or repeated dosing during diagnostic procedures such as CT, nuclear medicine and fluoroscopy. Risks associated with ionizing radiation in diagnostic imaging include cancer, burns and other injuries. Patients most at risk for harm are children and young adults, pregnant women, individuals with medical conditions sensitive to radiation such as diabetes mellitus and hyperthyroidism, and individuals receiving multiple doses over time. Not included in the Alert were issues surrounding therapeutic radiation or fluoroscopy.
So, you are asking, why should we be concerned? Invasive procedures in the EP lab are done under fluoroscopic guidance, so this Alert doesn’t apply to us. Or does it?
Care of the Patient Pre, Peri and Post Ventricular Tachycardia Ablation
- Fri, 8/12/11 - 3:20pm
- 0 Comments
- 2538 reads
Blog By: Tami Metz, RN
Ventricular tachycardia (VT) ablations can pose to be very complex in nature depending on the individual involved. It is important that each patient is thoroughly prepared and informed throughout the entire process that they are involved. Within this blog I will present the thorough process that we, at St. David's EP lab, initiate for all VT cases that come into our department.
The Future of Nursing
- Tue, 6/14/11 - 9:43am
- 0 Comments
- 1881 reads
Blog by: Melanie T. Gura, RN, MSN, CNS, CCDS, FHRS, FAHA, AACC
Since nursing is the largest percentage of the nations’ healthcare labor force and will play a critical role in helping realize the objectives of the 2010 Affordable Care Act, the Robert Wood Johnson Foundation and the Institute of Medicine (IOM) launched a two-year initiative in 2008, to review the need and transformation of the nursing profession. They released the IOM report on the Future of Nursing: Leading Change, Advancing Health,[1] which calls for new and expanded roles for nurses in a redesigned healthcare system.
Preventing Procedural Complications and Improving the Safety of AF Ablation
- Tue, 4/26/11 - 3:39pm
- 0 Comments
- 2103 reads
Blog by: Barbara Thomas, RN, FHRS
Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting nearly 3 million people in the US and about 4.5 million in the European Union, with 600,000–800,000 new cases per year. This arrhythmia is associated with a high incidence of stroke, as well as symptoms that significantly affect the quality of life of the patient. Catheter ablation is recognized as an effective treatment to cure AF, but ablative therapy is associated with significant risks for the patient. The most significant risks include thrombus/char formation, pericardial effusion, and esophageal fistula. It is important to recognize the complications related to AF ablation and to take proactive steps to minimize these risks in order to provide the best possible outcome for the patient.
So what can we do to prevent the risks of complications during AF ablation? Here are some suggestions:
Patient management of anticoagulation
1. Preprocedure:
Accountable Care Organizations and Nursing Quality
- Mon, 1/24/11 - 10:31am
- 2 Comments
- 1756 reads
Blog by: Melanie T. Gura, RN, MSN, CNS, CCDS, FHRS, FAHA, AACC and
Suzanne Hughes, RN, MSN, CNS, FAHA, FPCNA
Under section 3022 of the Patient Protection and Affordable Care Act, the Department of Health and Human Services must create by 2012 a Medicare “shared savings program” that permits groups of providers who meet certain statutory criteria to be recognized as Accountable Care Organizations (ACOs). Currently, our healthcare system pays hospitals to fill their beds and provide more tests and procedures. The ACO will shift the paradigm from a volume-based health delivery system to becoming a value-based health care system. An ACO is an organization of healthcare providers who agree to be accountable for quality, cost and overall care of patients assigned to the organization.
Creative Customer Service: A Tool for Weathering the Economic Storm
- Thu, 1/6/11 - 11:03am
- 0 Comments
- 844 reads
Hope
- Mon, 11/8/10 - 11:54am
- 0 Comments
- 895 reads
Each year we hold our annual pacemaker clinic patient education conference. This year the theme was biological pacing, an area of intense interest with our patient families. It seems that we are in the midst of a medical evolution with emerging developments in molecular and genetics research leading to a potential future of “personalized medicine”. Is the timing ripe to let our patients learn about this? Are we possibly opening up false hopes or unrealistic expectations?
Attempts and interest in biologic pacing began in the 1960s as researchers attempted sinus node transplants, followed by discovery of the pacemaker current (known as "If" or "funny current") in the 1980s, to the use of human mesenchymal cells to transfer pacemaker genes to the heart cells in early 2000. Dr. Michael Rosen served as the keynote speaker on "Biological Pacing: Dream or Reality" at our patient conference. As Dr. Michael Rosen puts it, "We’ll get there if we keep at it!"
Differentiating Between Nursing Scope of Practice and Standards of Care
- Tue, 10/5/10 - 2:20pm
- 3 Comments
- 2712 reads
Scope of practice refers to the professional activities defined under state law. The scope of practice for nurses is determined by each state’s nurse practice act.
Standard of care, on the other hand, refers to the provision of services in a manner consistent with care, as another professional with similar training and experience faced with a similar care situation would provide. Standards of care set minimum criteria for job proficiency. They define unequivocally what quality of care is and provide specific criteria that can be used to determine if quality of care has been provided. A divergence from standards of care may result in professional negligence.[1]
Effective Communication in the EP Lab Setting
- Wed, 9/1/10 - 4:00pm
- 3 Comments
- 2069 reads
Good communication skills are the ability of a person to communicate with the other in an effective manner. The electrophysiology lab requires effective communication among several disciplines and departments in order to run efficiently. Factors identified that are affected by communication include: patient care; procedural flow/scheduling; physician and employee satisfaction; interdepartmental relations; and patient outcomes. Within this blog I will describe the connection of communication and the several factors that are affected.
Patient Care:
It is imperative that all members of a specific EP lab communicate in order to provide exceptional care for the patient. The communication needs to involve each member of the team, equipment involved and physician. If anything is missed with this process, it could prove to be detrimental to the patient outcome.
Example: Communication of Heparin Administration.
