[gscott]

I am not an RN but a process engineer new to healthcare and working with cath labs in our area to streamline their operations...staffing has become a large issue and we are wondering what other staffing models are out there. You all seem to have tons of experience...how many people and of what training are in each lab during procedures? We have the attending, an RT, a monitor person, an RN, and a scrub. It sounds like you all have 2 RN's and the attending (?) I would love to hear your perspectives on what is really needed in the lab. I want to make sure that patients have what they need and that the room isn't congested - help?

[dianah]

There was a recent article in Cath Lab Digest discussing this very issue, and presented a poll from several labs re: crosstraining and staff positions.
There were a few differences in the Labs, but basically they operated with the same combination you have listed:
One Mod. Sedation RN
Someone who scrubs with the Attending (we have Fellows who do this)
Rad. Tech.
Circulator
= 5.

What can be a problem is maintaining adequate (minimum standard) staffing when there is no backup for vacations and unexpected time off (employee is ill or has to take care of family who is ill).

I'd be interested in seeing other replies.

[jrmom]

We have 2 labs:

lab A is older equipment(Seimen's) open from 730- 17:30. We do up to 17 cardiac cath cases , either femerol or radial in there. We have 3 RN's and the cardiologist (we are not a teaching hospital) One scrub, one circulator, one hemodynamic nurse. We use to use Rad techs yrs ago and had probs when the tech was not there and we closed the lab. We have a break nurse start at 930 in the morning and she starts to break the nurses one at a time so the lab does not stop . If you ask me, I wouldnt want to be the 17th patient. The staff are exhausted at the end of the day and the Dr is ready to drop, but it is all about the "numbers". Our sick time is horrible and the Overtime is off the charts! We have a very large turnover rate too.

Lab B newer GE equipment. That lab is open from 8 am and we do either a permanent pacemaker/ EP study/ ICD implantation until 9 30 .
At 930 we do up to 6 PCI's including, Rescues, Primary, Adhocs or booked Out patient/inpatients. That lab runs until 6 pm with the same staff ratio, no techs, only RNs.We do IABP, no surgery at our hospital, we are a stand alone PCI lab

We have our recovery area that has 10 beds, 5 chairs. We admit and recovery all patients there. We are also the regional cardiac centre and keep outpatients from other centres for 2 hours post procedure. Our femerol outpatients stay 4 hours post. That unit is open from 6 30 am till 9 30 pm.We also do outpatient cardioversions too daily

Our unit is busy!!!! We are tired LOL

[angel110600]

We have 8 cardiac cath labs and we are very very busy! We have 15 interventional cardiologists plus 3 electrophysiologist. We are a level II trama center located in the nations heartland. It is not a teaching hospital so we do not have fellows. We have approximatley 40 staff memebers. We usually run 3 to a room with at least one RN for sedation. We have a mix of RTR's and RN's. Our positions for a 3 person room are RN (sedation and patient care only!), scrub person, and recorder, circulate and RTR. OUr state requires there is an available RTR in the room at all times so we have to have at least one RTR that is not scrubbed in.

Most of the time we run 4 to a room with an RN, recorder, and scrub, and RTR. Usually this is for the hairy procedures, when things are complicated and can go south quickly. We have one physician who is VERY talented and all he does is interventions only. He does not see patients or have an office. He strictly does procedures 24/7. Our lab usually works well into the early morning hours to accommidate the need . He always is allowed 4 people to a room because his procedures are more complicated than the other physicians. Our relationship with our physicians is amazing! They are supportive and very flexible. We do our best to serve both our patients and the very busy cardiology practice. We only allow 3 staff memebers off at one time. We all have to live within 30 minutes of the hospital to be on call.

[jrmom]

Originally Posted by angel110600

We have 8 cardiac cath labs and we are very very busy! We have 15 interventional cardiologists plus 3 electrophysiologist. We are a level II trama center located in the nations heartland. It is not a teaching hospital so we do not have fellows. We have approximatley 40 staff memebers. We usually run 3 to a room with at least one RN for sedation. We have a mix of RTR's and RN's. Our positions for a 3 person room are RN (sedation and patient care only!), scrub person, and recorder, circulate and RTR. OUr state requires there is an available RTR in the room at all times so we have to have at least one RTR that is not scrubbed in.

Most of the time we run 4 to a room with an RN, recorder, and scrub, and RTR. Usually this is for the hairy procedures, when things are complicated and can go south quickly. We have one physician who is VERY talented and all he does is interventions only. He does not see patients or have an office. He strictly does procedures 24/7. Our lab usually works well into the early morning hours to accommidate the need . He always is allowed 4 people to a room because his procedures are more complicated than the other physicians. Our relationship with our physicians is amazing! They are supportive and very flexible. We do our best to serve both our patients and the very busy cardiology practice. We only allow 3 staff memebers off at one time. We all have to live within 30 minutes of the hospital to be on call.

We also have to live 30 mins of the hospital to take call. WE take call every 2 weeks, either the weekend or the mon-thurs run.
We have 5 interventionalists/ 1 EP / 12 invasive cardiologists. They all have office.

With our recovery area, we have a total of 15 staff on every day

[gscott]

Thank you so much for all the details! I can't imagine having the resources of all those doctors! We have 5 labs but only a handful of doctors that use them (5-7) on a regular basis. Thank you again!