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17 October 2018

Nurse-led cardiac procedure at Tauranga Hospital first in Australasia 

An award-winning Australasian first at Tauranga Hospital is seeing faster access for patients needing long-term heart monitors implanted.

Properly certified nurses carrying out implantable loop recorder (ILR) procedures is commonplace in the UK but Adrianne Escondo has become the first Australasian nurse to do the same.

Cardiac Catheter Laboratory (Cath Lab) nurse Adrianne has performed 20 of the procedures, which cardiologists traditionally perform in theatre. And the benefits of the nurse-led initiative were recently recognised with a Cardiac Society of Australia and New Zealand (CSANZ) award.

"It's freeing up our theatres and cardiologists to concentrate on more specialist procedures such as pacemaker, ICD (implantable cardioverter-defibrillator), CRT-D (cardiac resynchronization therapy defibrillator) implants and coronary angiography. Those patients are being seen much sooner as are the patients needing an ILR," said Adrianne, who became certified to insert ILRs last year.

ILRs are small heart monitoring devices implanted just under the skin in the chest. It takes about 3-5 minutes to implant the heart monitor in the patient's chest in a low-risk procedure under local anaesthetic.

The recorders are typically used for patients with unexplained heart palpitations, sudden light-headedness, dizziness or fainting that are suspicious of irregular heart rhythms. Cardiologists use information captured on them to determine diagnosis and develop a treatment plan.

Adrianne said performing the procedure in the Day Stay area rather than theatre was also having a positive impact on patients. 

"For some the prospect of going to theatre raises anxiety levels, especially when the heart's involved. There is comfort in having the procedure done in a non-theatre environment," he said.

The idea of a cardiac nurse performing the procedure stemmed from the UK. Several NHS hospitals have cardiac nurses inserting the long-term heart monitors. 

Tauranga Hospital's Cath Lab opened 18 months ago (the BOPDHB previously operated a shared service and an independent Cath lab). Described as a one-stop shop for heart patients, around 1600 cardiac procedures including inserting pacemakers, defibrillators and stents, have been performed onsite. That has boosted cardiac procedures by 20% and has reduced the need for patients to travel to Waikato for these specialist services.

Cath Lab
Cardiology Clinical Nurse Manager Jason Money acts as 'the patient' as Cardiac Nurse Adrianne Escondo and Cardiac Physiologist Tracey Cumming demonstrate where the procedure is carried out in a non-theatre environment.

 

James Fuller
Communications Advisor - Bay of Plenty District Health Board

Last updated: October 24, 2018