Published Jul 30, 2019
icuhopeful
8 Posts
Hello fellow critical nurses!!
My employer wants our ICU to start taking patients post heart cath with impella pumps. They have offered a 2 hour training course (impella representative with machine only).I have looked online for how other facilities train their staff, competencies, hours with a patient with impella etc. I can’t seem to find anything. Is this the norm now? How have you been trained on this device?
NGjuice
3 Posts
That's what my facility did. We also did an online course prior to the in person class. The representatives were really good. We got to see one and play with it.
I can also say, the impella people have been really supportive and helpful. We still don't use them routinely, so the representative comes out almost every time to make sure it's set up correctly. We all have his number to call for questions. There's also a 1-800 on the machine. They are super helpful and talk you through everything you could possible need.
The down side in my hospital is half the doctors have no idea what to order for them or what lines to place for us to use after the procedure. We've had to place art lines after the fact so we can do our ACTs. We spend an hour getting the order set entered correctly. It's usually a 3-4 hour cluster any time one comes to the unit. And then the site ALWAYS ends up oozing.
But, all in all, they aren't the worst patients I've had to take care of. And the company is very supportive. Hope that helps!
Thank
1 hour ago, NGjuice said:That's what my facility did. We also did an online course prior to the in person class. The representatives were really good. We got to see one and play with it. I can also say, the impella people have been really supportive and helpful. We still don't use them routinely, so the representative comes out almost every time to make sure it's set up correctly. We all have his number to call for questions. There's also a 1-800 on the machine. They are super helpful and talk you through everything you could possible need. The down side in my hospital is half the doctors have no idea what to order for them or what lines to place for us to use after the procedure. We've had to place art lines after the fact so we can do our ACTs. We spend an hour getting the order set entered correctly. It's usually a 3-4 hour cluster any time one comes to the unit. And then the site ALWAYS ends up oozing. But, all in all, they aren't the worst patients I've had to take care of. And the company is very supportive. Hope that helps!
Thank you!! You were very helpful. I suspect I will be calling the 1-800 often.
Cheers?
smf0903
845 Posts
We use IABPs as opposed to Impellas but we got an online course and about a 2-hour deal with a rep. We were told we wouldn’t have any balloon pumps for a long while and we showed up to work one day and guess what? Patient on a balloon pump ?
The rep we called the one time was less than helpful.
anchorRN, BSN, MSN, RN, APRN
279 Posts
We do Impella fairly often, but use more IABPs. When we do have an Impella the rep always comes into town, checks on the patient daily, and calls once per shift (day and night). I feel they've been very helpful with the ones we've had. They basically run themselves as long as the catheter stays in position. The most common alarm we get is a suction alarm and its easily fixed with a 250ml fluid bolus. I had one the other day and the groin insertion site was oozy but a quick stitch fixed it.
3 hours ago, anchorRN said:We do Impella fairly often, but use more IABPs. When we do have an Impella the rep always comes into town, checks on the patient daily, and calls once per shift (day and night). I feel they've been very helpful with the ones we've had. They basically run themselves as long as the catheter stays in position. The most common alarm we get is a suction alarm and its easily fixed with a 250ml fluid bolus. I had one the other day and the groin insertion site was oozy but a quick stitch fixed it.
Thank you!! I am still concerned about the lack of training for a life saving device. I’m glad to hear the reps are so responsive to the bedside nurses needs.
PeakRN
547 Posts
Whenever we have a new device we spend typically 2-4 hours in a course and then typically one shift at the bedside orienting (whether this is for impellas, IABP, CRRT, HFOV/JETs, and so on).
We will try to orient a core team in another unit of someone else is already implementing a device, at a sister hospital, or sometimes at another hospital (typically for ECMO related devices) in the region.
On occasion there are devices that are either brand new to the market or just aren't feasible to have an orientation shift at the bedside (especially for things like rapid infusers, some hemodynamic monitors, and bedside lab equipment). In these cases we will set up a wet lab.
pRNb
2 Posts
We've started utilizing Impella recently in our organization as well. I am not impressed with the companies support of the device post cath procedure. It is a very low volume/high risk event for critical care as most impellas are removed in the cath lab. The rep spends a considerable amount of time in the cath lab during the procedures for support and education so our cardiologists are proficient but appears to have no interest in supporting areas outside of critical care.
What has been the outcomes of your patients that require support outside of the cath lab?
CCU BSN RN
280 Posts
We do the Impella company's online training and then a 4h in-service with the Impella rep. They call at least every shift to ask a bunch of questions but honestly, it's usually a huge imposition. Last time I had one they called 4 times while we were coding the patient and were pretty pissed that I didn't have time to take their call. Also I feel like I've never gotten a CXR where the very minimal movement to get the board under them hasn't displaced the Impella. Huge PITA to get the orderset properly ordered and to get a doc to reposition overnight. Then the docs don't seem to know how to manage them so you'll have suction alarms and it'll take hours to get a fluid bolus ordered even when you have the Impella manual opened to the proper page for them to review. I literally don't know how I could spell it out any clearer for them.