morris_88

My current hospital has followed the trend of developing hybrid ORs. The hybrid ORs are being used for multiple open vascular, endovascular cases, and Trans Aortic Valve Replacements (TAVR). The TAVRs involve endovascular personnel, invasive and noninvasive cardiology, and an open cardiothoracic team (standby). These procedures are new for everyone and working with that many departments can be stressful. I am an open cardiac nurse and our team is used as standby in the event that the procedure would convert to an open. I am the only registered nurse in the room and I am required to run the room and circulate for the procedure. I do not know enough of the endovascular equipment that is used or anything regarding the charting such as sheath size, placement time, removal time, closure device placement and time, TR band application and CCs used required for PCI. I have voiced multiple patient safety concerns to my supervisors and managers. The most recent was regarding the documentation of heparinized saline that is on the sterile field. The heparinized saline is used to flush sheaths, wet wires, etc. It is NOT injected into the patient. I had asked the college coordinator for endovascular how they documented the heparinized saline solution for all the other procedures that way I could document it correctly. Her answer was we do not document heparinized saline as a medication in any endovascular, cath lab, EP, room. So there is no record of it being used....period. It is not injected into the patient it is ONLY used as a flush for sheaths and to wet wires. I was wondering what others thoughts were on this... I find this to be disturbing... how can it not be documented. I have tried to research articles or situations like this but have I found nothing. Anyone have any suggestions or articles?????