January 12, 2012

Cardiac cath lab team takes Magnet lessons to heart

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Team members from the Adult Cardiac Catheterization and Electrophysiology Lab have been holding monthly meetings to prepare for VUMC’s upcoming Magnet site visit. (Photo by Anne Rayner)

Cardiac cath lab team takes Magnet lessons to heart

The Adult Cardiac Catheterization and Electrophysiology (EP) Lab thrives on collaboration and teamwork and perfectly highlights why Vanderbilt University Medical Center is pursuing a second Magnet designation.

The lab’s 50 nurses work closely with technicians, proceduralists and physicians to care for patients at a time when teamwork is essential. Patients are often in the midst of a heart attack, and time saved equals lives saved.

“Teamwork is a huge part of our practice,” said Rachel Provost, R.N., “We average 49.5 minutes door-to-balloon time, which speaks to how great we work together.” (The American Heart Association recommends a door-to-balloon time of no more than 90 minutes.)

The strong team culture is also evident in the monthly meetings to prepare for VUMC’s upcoming Magnet site visit Feb. 20-24. Though the Magnet designation specifically relates to nurses, technicians also participate the meetings.

“We have included the techs too because we work so closely as a team and what affects nurses affects everyone else,” Provost said.

Provost is a Magnet Champion for the lab. Champions serve as front-line activists during the second designation process, helping to educate their colleagues about Magnet. There are more than 200 Magnet Champions volunteering across VUMC.

“All of us think Rachel is fantastic. We call her ‘Miss Vanderbilt.’ I can’t think of anyone who exemplifies Credo behavior like she does. We’re fortunate that she is willing to get involved and build our excitement for Magnet,” said Amanda Williamson, R.N., nurse educator for the cath lab.

On one cold, wintry morning, Provost had her colleagues engaged in a heated battle – a quiz game testing their knowledge of Magnet’s 5 Essential Elements: transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovations and improvements; and empirical quality outcomes.

“What are the three main goals for our unit?” Provost asked, and a team correctly answered, “Safety, quality and correct handovers.”

One question highlighted the use of evidence-based practice. After nursing research found that the use of the local anesthetic Lidocaine when pulling sheaths in the holding room actually increased pain rather than decreased it, plus incurred the patient more cost, they discontinued its use.

Another question asked about efforts to reduce skin breakdown, which include no longer doubling sheets and making sure patients do not have multiple linen layers under them after a transfer.

Though everyone seemed to enjoy the friendly competition of the quiz game, Provost stressed that Magnet is not just about knowing the correct answers to questions.

“If we understand the Magnet guidelines and internalize them, we’ll practice Magnet all the time. It’s not just about the site visit in February, it’s about building a Magnet culture,” she said.

Provost and Williamson also created a Magnet Prep Study Guide for each person in the lab, which includes educational materials that they are constantly adding to. They also maintain a bulletin board in the staff break room that highlight’s the lab’s Magnet behaviors.

One of their proudest achievements is the observed-to-expected mortality rate. Their goal was to save 29 expected deaths in fiscal year 2011, but it was actually much higher at 39.

“It takes a little bit from everybody to make a strong unit and department, and we are certainly good at working together,” said manager Dana Wilson, R.N., MBA. “Communication is also key, and Rachel has been so great at creating the posters and handouts, highlighting the great work we do every day, and getting us ready for Magnet.”