Email Discussion Group: April 2007

New Questions: Skills List for Nurses Working in the EP Lab We are revising our policies and procedures manual, and I wanted to include a skills list for EP nurses. Would you know where I could find this information in order to tailor one for my department? Jacqueline Owen, RN/EP Nurse (To reply to this question, please type Skills List in your subject line.) Table Set-Up We need some advice in reference to setting tables for diagnostic cases. Do any labs out there have policies or written procedures for gowning and gloving to set tables? The staff at a lab I used to work at just put on gloves to set tables this went on for 18 years without any infection problems. Now new infection control people from surgery have stated that everyone should mask, gown, and glove. Is there any data out there to support either case? Rick Smith, CVT (To reply to this question, please type Table Set-Up in your subject line.) Under Discussion: Billing for Transseptal Punctures I have a question regarding billing for transseptal punctures. Our billing department at New York Hospital states that we cannot bill for a transseptal puncture during an AF ablation because it falls under the category of access. This is confusing to me as the cath side can bill for the same procedure under a valvuloplasty. How do other institutions, or do you, bill for this portion of the AF procedure? Thanks. Edmund Donovan, RN, CN II, New York Presbyterian Hospital, New York, NY (To reply to this question, please type Billing in your subject line.) We do not perform atrial fibrillation ablations at our institution, but we do perform transseptals for accessory pathways on the left side of the heart. We cannot bill for the transseptal procedure, but do for all disposables used, mapping performed. The key to billing for a transseptal is to record and monitor the left atrial pressure, I believe. I'm not 100 percent sure, but I think that makes billing for the transseptal procedure legal. Check with your resource person on this issue. Dana St. John, RN Additional Questions For Discussion: Grounding Pads We need some advice in reference to the correct placement of the grounding pad for RF ablation. In our lab, we have placed the pad toward the left side of the upper back. Are there alternative sites that can be used for RF ablation? Elizabeth Gotay, EP RN (To reply to this question, please type Grounding Pads in your subject line.) EP Lab Clinical Nurse Specialist I'm looking for a job description for an EP Lab Nurse Specialist. This would be someone who does all aspects of procedures and also staff education, patient pre- and post-teaching, including post-procedure follow-up. David Reynolds, RN/RCIS, Southwest Washington Medical Center, Vancouver, WA (To reply to this question, please type Nurse Specialist in your subject line.) Prerequisites for Transitioning from Cath to EP As with the excellent description of Lancaster General's in-house EP training, I'm looking for either competency statements or examples of performance reviews for a new lab. Any input? Jerome Leblanc, RCIS (To reply to this question, please type From Cath to EP in your subject line.) Device Cases Recently one of our physicians asked our staff members if we can obtain the training to close the pocket of a pacemaker, ICD, or a Reveal. Currently at our hospital, the only people that can close the pocket are physicians, residents, and First Assistants (FAs). To obtain a First Assistant certification, most places want you to be a current scrub tech or RN with 3+ years experience in the OR. The problem is that in our EP lab, RTs and one scrub tech are the only people that assist with the implant cases. Therefore, we fall out of the RN/ST category as a whole. We are also in a very rural area, so the classes offered are all out of state. What are other EP labs doing for an RT(R) to be able to close the pocket, if your hospital allows it? Jonathan Sheets, RT(R) (To reply to this question, please type Device Cases in your subject line.) Working in the US: State Licensing I am a cardiac physiologist (CVT) from the United Kingdom, and am trying to find out about state licensing. Do I need to be licensed to work in the US? There seems to be variance from state to state. Stuart Allen, Southampton General Hospital, Southampton, Hants, UK (To reply to this question, please type Working in the US in your subject line.) Stereotaxis Niobe vs. Hansen Sensei I am interested in opinions from clinicians who have experience using the Stereotaxis Niobe 2 system and Hansen Medical's Sensei system. Feel free to express any thoughts regarding ease of use, economics, clinical efficacy, procedure speeds, safety, etc. I am especially interested in those clinicians who have performed human procedures using the Hansen system. anonymous (To reply to this question, please type Stereotaxis vs. Hansen in your subject line.) Training Classes I am looking for electrophysiology classes for a radiologic technologist. I hear there is a hospital in Lancaster, Pennsylvania, that may have classes. Does anyone know anything about this? It can be in any eastern state, but Pennsylvania is close to me. I am looking for training classes that are about 2 - 3 days long. Please list places and contact information.   Di Robbins (To reply to this question, please type Training Classes in your subject line.)