The Cardiac Catheterization lab at Hartford Hospital is comprised of four suites, two monitoring rooms, two scrub areas, a supply room and a holding area.
There are approximately 5,000 diagnostic cardiac caths done per year and of these, 1,500 become interventions. Hartford Hospital’s operating room provides 24-hour backup in the event that open-heart surgery is needed.
The staff has a wide variety of degrees and backgrounds. There are 11 nurses with degrees ranging from LPN to BSN. There are also 9 Technologists with credentials ranging from CVT to RCIS. Our nurses and technologists joined the Hartford Hospital staff from many other organizations including Brigham and Women’s, Beth Israel, Johns Hopkins, and the Miami Heart Institute among others. Five secretaries and 3 transporters round out the team and provide needed support to the staff and patients.
Shifts in the lab vary from eight to ten hour days with days off during the week for ten-hour shifts. Some staff members are part time. The call team stays for cases that run after regular hours and STAT cases during the night hours. A call team consists of a nurse, a technologist, a physician, and a fellow. Recently the cath lab instituted a new concept of an extra call person. This person (nurse or technologist) volunteers to be the third call person. The extra person has proved many times over to be beneficial to the call team and patient care.
Hartford Hospital is a teaching institution. Fellows spend a year in interventional cardiology program before graduating. Typically, the fellow scrubs in with the interventional cardiologist for the PCIs. The Registered Nurse in the room circulates, monitors the patient, and administers medications. The Technologist also monitors the patient, concentrating on patient vital signs, and assists the physician with supplies. If a fellow is not available and an assistant is needed, a technologist will assist with the intervention.
Hartford Hospital’s Cath lab has recently added procedures to the list of services that it provides for the community. Percutaneous interventions for PFOs have been performed with great success since March of 2002. Approximately 50 patients have undergone PFO closure to date. Brachy therapy with both beta or gamma radiation has been available to patients since November of 2001 and approximately 100 patients have undergone this procedure. The interventional cardiologists are beginning to perform peripheral interventions within the lab and are expected to perform approximately 50 procedures per year.
Hartford Hospital has been filmless since November, 2001. This upgrade in technology has eased the transfer of information especially between Hartford Hospital and its affiliated institutions and has improved the capability to communicate with patients and family. The close proximity of the physician’s offices (each with digital viewing stations) and the waiting area allows the patient’s families to be included in the care of the patient.
Hartford Hospital cath lab is actively involved in research. Current cardiac lab research projects include ANTHEM/TIMI-32, CREST, ASTEROID, CAPTIVE, ADVANCE MI, JUMBO and CHARISMA. Hartford Hospital is also a co-chairing site for the nationwide study-COURAGE. A new database center (Cardiovascular Data Management Center, CDMC, for short) is being developed. Part of this group’s task will be to concentrate on the data collection and management of patients who have had an AMI, PCI, or OHS. The center will also be involved in the long-term follow up of all patients who have an interventional procedure such as Brachy therapy and PCI. Quality control, patient satisfaction and outcomes are a large part of the process.
A variety of educational opportunities are available to the staff. These are in the form of in-services and presentations from vendors on current and new therapies. Staff members also attend national conferences and the annual cardiovascular symposium held at Hartford Hospital. Staff from the cath lab are involved in the Cardiology Education Council and assisted in a teambuilding seminar that brought together staff from all areas of cardiology.
The patient volume continues to grow for the Hartford Hospital cath lab along with the number of procedures available to patients and their families. The experienced staff of the Hartford Hospital cath lab has met this growing challenge through innovative, flexible staffing and management, continuing education, research, and a dedication to provide the best possible care to Hartford and the surrounding communities.