Feature | March 20, 2012

SCAI Publishes Best Practices for Cath Labs

March 20, 2012 – The Society for Cardiovascular Angiography and Interventions (SCAI) published a first-of-its-kind paper defining best practices in the cardiac catheterization laboratory, commonly referred to as the cath lab. The paper is part of SCAI’s ongoing effort aimed to ensure the highest quality care and safety for patients undergoing interventional cardiology procedures such as angioplasty and stenting (also known as percutaneous coronary intervention or PCI). Titled “Clinical Expert Consensus Statement on Best Practices in the Cardiac Catheterization Laboratory,” the paper is e-published in Catheterization and Cardiovascular Interventions.

Just as a surgical suite serves patients requiring surgery, cath labs support procedures that require catheterization, whereby a small, flexible tube called a catheter is inserted into an artery in the patient’s upper leg or wrist to access the heart arteries and clear blockages. The cath lab is where heart attacks are stopped and where patients suffering from various forms of heart disease are treated for symptom relief and improvements in quality of life.

“Interventional cardiologists are guided by a number of quality improvement tools, including guidelines and appropriate use criteria, but consensus opinion on best practices for how to run these cath labs has been missing until now,” said Srihari S. Naidu, M.D., FSCAI, SCAI trustee and director of the cardiac catheterization laboratory at Winthrop University Hospital, Long Island, NY, and lead author of the paper. “This paper represents the most current, evidence-based approach to continually improving the safety and care of interventional cardiology patients in cath labs across the country and the world.”
 
The paper published recommends best practices that should be upheld by interventional cardiologists and other medical staff performing procedures in the cath lab setting. The best practices are divided into three categories: before the procedure, during and after the procedure, including follow-up evaluation, and feature the following highlights:

  • Assembling an optimal cardiac catheterization team. Physicians should maintain proper credentialing and other members of the medical staff should also have the proper certifications and experience. In addition, procedure outcomes, including success rates and observed complications, should be documented.
  • A pre-procedure checklist for cardiac catheterization that guides the attending physician through a list of questions to review and verify prior to initiating the procedure. A common tool used in other medical specialties, the checklist includes affirmation of the procedure type, pre-catheterization assessments, as well as reviewing the patient’s health history, ability to adhere to medication regimens, informed consent, sedation, and allergies.
  • Receiving informed consent. Included within pre-procedure best practices is the importance of receiving informed consent from the patient, ideally with a third-party witness. The paper points out the importance of verifying the patient fully understands what the procedure entails; the risks, benefits and alternatives to the treatment proposed; as well as potential outcomes and complications that may occur during and after the procedure.
  • A recommended “time out” protocol to be performed immediately before the procedure and when all members of the medical team are present. During this “time out” period, patient identification is verified, as is procedure route, procedure equipment, patient allergies and special medical conditions.
  • Patient preparation in the procedure room. Best practices during the procedure include a thorough review of the patient’s medical record, access site concerns, allergies, blood test results, recent medications, advance directives, informed consent and living wills.
  • Appropriate post-procedure communications and evaluation. Following the procedure, the patient must be carefully monitored during the hospital stay. The physician should discuss the results of the procedure, as well as complications, unexpected findings and events with the patient and family as well as with the healthcare providers who will assume care of the patient. The physician should also explain the important role of patient adherence with prescribed medications.
  • Planned follow up. Best post-procedure practices include scheduling the patient’s follow-up appointment two to four weeks after discharge to confirm the access site is healing, ascertain that there are no medication complications or problems with adherence, evaluate current lifestyle limitations and enroll in cardiac rehabilitation.
  • Quality assurance protocols. Each cardiac cath lab should have processes in place for nonbiased, education-based peer review of procedures. “SCAI’s commitment to quality improvement is unwavering, and we are confident this paper will only serve to improve cath labs and the work we do for our patients,” said Christopher J. White, M.D., FSCAI, SCAI president and professor and system chairman of cardiovascular diseases at the John Ochsner Heart & Vascular Institute, New Orleans, La. “This paper will provide a benchmark for cath labs to base their current practices on and help set future goals elevating the standard of patient care across the practice.”

 

“Clinical Expert Consensus Statement on Best Practices in the Cardiac Catheterization Laboratory,” along with the full issue of Catheterization and Cardiovascular Interventions, is available via www.scai.org.

Related Content

Abiomed, Impella heart pump, 50,000 patients treated, United States, milestone
News | Ventricular Assist Devices (VAD)| February 24, 2017
Abiomed Inc. announced that it has supported more than 50,000 patients in the U.S. with its Impella line of heart pumps...
coordinated heart attack care, Ontario STEMI Bypass Protocol, Canada
News | Cath Lab| February 22, 2017
Two new Ontario-wide heart attack protocols for paramedic services and emergency departments that aim to saves lives...
transradial approach, same-day cardiac procedures, radial access, $300 million annual savings, JACC Cardiovascular Interventions study
News | Radial Access| February 22, 2017
If hospitals can perform more transradial, same-day percutaneous coronary intervention (PCI), hospitals across the U.S...
Technology | Radial Access| February 17, 2017
Medtronic plc announced that its coronary portfolio will now include the DxTerity Diagnostic Angiography Catheter line...
Sponsored Content | Videos | Inventory Management| February 17, 2017
The supplies you use in your cath lab are complex and very valuable.
Mercator MedSystems, DANCE trial data, ISET, LINC, Bullfrog Micro-Infusion Device
News | Peripheral Arterial Disease (PAD)| February 15, 2017
Mercator MedSystems announced that the national co-principal investigators of the company’s DANCE trial each presented...
Cardinal Health survey, hospital staff, supply chain management, quality of care
News | Inventory Management| February 15, 2017
Better hospital supply chain management leads to better quality of care and supports patient safety, according to a new...
University of Alabama at Birmingham, Amplatzer PFO Occluder, first implementation
News | Structural Heart Occluders| February 15, 2017
Doctors at the University of Alabama at Birmingham have implemented the first U.S. Food and Drug Administration (FDA)-...
Biotronik, PRO-Kinetic Energy cobalt chromium coronary stent system, FDA approval
Technology | Stents Bare Metal| February 15, 2017
The PRO-Kinetic Energy Cobalt Chromium (CoCr) Coronary Stent System from Biotronik has gained U.S. Food and Drug...
heart team, hybird OR, structural heart team

The heart team approach was first used on a large scale in the CoreValve and Sapien TAVR trials and helped lead to excellent outcomes in high-risk patients.

Feature | Hybrid OR| February 15, 2017 | Dave Fornell
In the current era of healthcare reform and the push toward evidence-based medicine to both lower costs and improve p
Overlay Init