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Cath Lab Textbooks

Supporting Staff: The Cath Lab Visual Orientation Manual as a Valuable Resource

Samantha Propper, MBA, BS, RCIS
CEO, Propper Consulting, LLC, DBA: Don’t Miss A Beat

Email: samanthapropper@dontmissabeat.info
Website: https://dontmissabeat.myshopify.com

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10/03/2023

As the complexity of cases in the cath lab continues to rise with three-vessel Impella (Abiomed)-supported percutaneous coronary intervention (PCI), chronic total occlusion (CTO) interventions, and robust structural heart programs, it's more important than ever for the cath lab team to have access to educational resources that can help them stay up to date and improve their skills. The Cath Lab Visual Orientation Manual1 is one such resource that can be incredibly valuable for respiratory therapists, cardiovascular technologists, registered cardiovascular invasive specialists, diagnostic and interventional fellows, radiologic technologists, and registered nurses who work in the cath lab providing comprehensive information and enhanced visuals on every page (Video 1).

 

Video 1. Video recording featuring the visual pages included in The Cath Lab Visual Orientation Manual (hard copy).

 

What is the Cath Lab Visual Orientation Manual? 

Figure 1. Image featuring the cover photo of The Cath Lab Visual Orientation Manual
Figure 1. Image featuring the cover photo of The Cath Lab Visual Orientation Manual

The Cath Lab Visual Orientation Manual (Figure 1) is a comprehensive guide that covers both the basics of cath lab procedures and more complex topics relevant for seasoned professionals. It is designed to be a go-to resource staff can refer to when they have questions about why something was used in a case or when they want to prepare for a case. The Cath Lab Visual Orientation Manual is available in two convenient formats: a hard copy and a digital copy. Employees can easily access the digital version on their phones or have it printed for use in the lab (Video 2).

 

Video 2. Video recording featuring the digital pages and zoom features in The Cath Lab Visual Orientation Manual (digital).

 

Figure 2. Image featuring a page from The Cath Lab Visual Orientation Manual featuring diagnostic vs guide catheters. 
Figure 2. Image featuring a page from The Cath Lab Visual Orientation Manual featuring diagnostic vs guide catheters. 
Figure 3. Image featuring a page from The Cath Lab Visual Orientation Manual featuring IVUS imaging.
Figure 3. Image featuring a page from The Cath Lab Visual Orientation Manual featuring IVUS imaging.

With detailed illustrations and diagrams, the manual offers an in-depth understanding of the procedures and equipment involved in cases. Its user-friendly layout allows staff to quickly find the information they need. Take a look at some of the examples in Figure 2 (diagnostic versus guide catheter) and Figure 3 (intravascular ultrasound [IVUS] imaging).

The guide is structured chronologically, starting from day 1 in the cath lab. It is divided into six main chapters:

  1. Welcome To The Cath Lab: Procedure Room, Control Room, The Team, How to Be Successful
     
  2. Patient Preparation & Safety In the Lab: Radiation Source, Dose, Sterility, Patient Prep, Consents, Time Out
     
  3. Non-Invasive: Labs, 12 Lead, Rhythms, TTE, TEE
     
  4. Pharmacology: Sedation, Anticoagulation, Radial Cocktail, No Reflow Medications, Contrast, Antiplatelets, DAPT
     
  5. Diagnostic Heart Cath: Terminology, Sheath, Venous and Arterial Access, Wire Tips, Left Heart Catheters, Right Heart Catheters and Procedure, Guide vs Diagnostic Cath, Coronary Anatomy, Hemodynamics (Atrial, Ventricular, Arterial, Normals, Hallmarks, Aortic Stenosis), Atherosclerosis, Heart Failure, Shock, Left Ventriculogram Views, Coronary Views, Ventricularization vs Dampening, CABG, Collaterals
     
  6. Interventions: Terminology, Rotational and Orbital Atherectomy, Thrombectomy: Manual & Mechanical, Laser, Lithotripsy, OCT, IVUS, IABP, Complications: No Reflow & Stroke, Edwards TAVR Valve, Medtronic TAVR Valve

The Versatility of the Cath Lab Visual Orientation Manual

The Cath Lab Visual Orientation Manual can be utilized in various ways to optimize staff performance:

●      In-lab resource: When encountering new equipment or procedures during a case, staff members can refer to the manual for detailed information. This ensures a deeper understanding of why certain equipment or procedures are being used and how to use them correctly. It also provides quick access to definitions of unfamiliar terms used during procedures.

●      Education and onboarding: The manual is an invaluable resource for onboarding new staff members, providing them with comprehensive information about Cath Lab procedures and equipment from their very first day. It also serves as a valuable tool for continuous training and development for experienced professionals.

Expanding Knowledge: The Diagnostic Peripheral Expansion and The Visual Impella Expansion

Figure 4. Image featuring The Diagnostic Peripheral Expansion and The Visual Impella Expansion.
Figure 4. Image featuring The Diagnostic Peripheral Expansion and The Visual Impella Expansion.
Figure 5. Image featuring pages from The Visual Impella Expansion.
Figure 5. Image featuring pages from The Visual Impella Expansion.

In addition to the Cath Lab Visual Orientation Manual, we have recently introduced two expansions: The Diagnostic Peripheral Expansion and The Visual Impella Expansion (Figure 4). These expansions are designed to provide detailed information on specific topics, allowing orientees to build their knowledge and confidence as they progress beyond training. The expansions, available in both physical and digital formats, consist of 25-40 pages dedicated to their respective titles, and you can view the full table of contents on the website.

By integrating these expansions into the cath lab's educational resources, new hires and experienced staff members alike can access specialized information based on the specific modalities offered in your lab. This integration ensures the team is equipped to handle the growing complexity of cases and advancements in the field in a visual and clear way (Figure 5).

Why are Educational Resources for Staff Valuable?

As noted by Youmans et al in their article Turnover of Cath Lab Staff: Is Complexity To Blame?2 on the challenges of staff turnover in the cath lab, increasing case complexity is a significant factor in the turnover of cath lab staff members. As cases become more complex, staff members need to have a strong foundation of knowledge and skills in order to be successful and feel confident in their job. This highlights the importance of education and training in the lab.

While the Cath Lab Visual Orientation Manual can certainly be an important educational resource, it is just one piece of a larger solution to the challenges faced by teams. As Youmans et al suggest, ongoing training and development opportunities can help staff members develop new skills and stay up-to-date with the latest advances in procedures and equipment. Creating a positive work environment that supports collaboration and learning is also crucial to improve employee retention, morale, patient outcomes and productivity.

Here are a few ideas to help foster a culture of collaboration and learning within your Cath Lab team:

Quarterly or Yearly Internal Conference

Host a quarterly or yearly internal conference where physicians can discuss complex cases encountered during that time period, share strategies, and find resolutions to problems as a team. This conference can be a great opportunity for your team to learn from each other, explore new technologies, and develop new skills. As a result, it can help improve the quality of care you provide to your patients.

In-Service Staff Meetings

During monthly scheduled staff meetings, invite device representatives to come in and provide training to your staff. These meetings can be an excellent opportunity to keep your team up-to-date with the latest technologies, techniques, and best practices. It’s essential to ensure your staff is engaged during these meetings, and a low-stress and non-rushed time block can help facilitate a more productive and positive experience.

Debrief Sessions

Consider having physicians come during the staff meeting for a 30-minute debrief session to discuss a previous case and provide feedback on what could have gone better. These debrief sessions can be invaluable in helping your team learn from their experiences and develop new skills to provide better patient care.

Overall, addressing the larger issues of turnover and complexity in the Cath Lab requires a multifaceted approach that includes investing in education and training, fostering a positive work environment, and utilizing other solutions to support staff members and contribute to better outcomes for patients.

References

1. Propper, S. Cath Lab Visual Orientation Manual. Shopify: Orlando, FL; 2023.

2. Youmans A, Kern M, Klein L, Lim M, Ramee S. Turnover in the cath lab: is complexity to blame? Cath Lab Digest. 2022 Jan; 30(1): 1-4. https://www.cathlabdigest.com/article/Turnover-Cath-Lab-Complexity-Blame

Disclosure: In this article, I reference my published books as a resource for readers. As the owner of the books, I may have a personal interest in promoting it. However, I believe that the content in the books can be valuable to readers and I have included them in this article with the intention of providing helpful information. Please note that any views or opinions expressed on the accounts are my own and not necessarily reflective of the views or opinions of any organizations or individuals mentioned in this article.

Author Headshot, The Diagnostic Peripheral Expansion and The Visual Impella Expansion product photo and The Visual Impella Expansion pages photo provided by: Rebekah Pittman Photography LLC

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