evolution of the cath lab

nurse / tech role

Brenda McCulloch RN MSN RCIS

Cardiovascular Clinical Nurse Specialist

Sutter Heart & Vascular Institute

Sacramento, CA

mccullb@sutterhealth.org

evolution: change over time

diagnostic studies to catheter-based,

non-surgical intervention

a gradual process in which something changes

into a different and usually more complex or better form

Hales, 17112011

Dr. Mason Sones / Cleveland Clinic - 1958

Dr. Melvin Judkins – 1968

University of Oregon

Andreas Gruentzig - 1980

Emory University

early beginnings

• 1940-1950 – early beginnings – growth due to

increasing successes in cardiac surgery

• 1970-1990 – proliferation of cath labs

– 1977 balloon angioplasty; 1986 stent

– few references to non-physicians in the cath lab

• 1991 – guidelines provide staffing skill set

recommendations for nurses and technologists

in the cath lab (Pepine, CJ et al, 1991)

evolution of technology

cradle table

dark room and

processor,

fixer/developer

green dye outputs

targano projector

digital

flat panel

computers

web-based viewing

hybrid surgical suites

data reporting

evolution of cath lab staff

• 1-2 staff assistants in 70’s – 80’s

• in early days of PCI, 2 MD’s common

• technology changes drive staffing changes

– increased sub-specialization : coronary/

cardiac, electrophysiology, peripheral

– IT specialists

– inventory/purchasing specialists

– support staff

c. 1988

cath lab staff development

• otj training

• cv programs

• live case demonstrations, cath conferences

• continuing education

• cross-training

• journals, texts

• internet

• simulation training

RCIS

recognized by the American College of Cardiology (ACC) and by the Society for Cardiovascular Angiography and Interventions (SCAI)

other licensed allied health professionals not currently holding the RCIS should obtain the RCIS within two years of full time employment in the CCL

offered by Cardiovascular Credentialing International (CCI)

(SICP, 2010)

professional development

• advanced procedures – closure devices

• active participation in departmental & hospital-

wide committees

• surveys, accreditation

• professional organizations – ACC, SICP, SCAI

share your knowledge & skills

• teach

• precept

• mentor

• publish