Objective: To evaluate the safety, effectiveness and quality of a nurse led coronary angiography service.
Methods: A senior cardiac catheter laboratory sister was trained in cardiac catheterization simultaneously with a first year cardiology medical registrar by consultants in our unit. 250 consecutive cases (acute and elective) were recorded in a log book documenting success rates in arterial access, coronary intubation, achievement of haemostasis using vascular closure devices and the ability to accurately interpret the coronary angiogram (effectiveness). Safety was measured by assessing adverse outcomes (stroke, heart attack, death and bleeding). Quality was measured by recording X ray time (mins) and contrast usage (mls). A final report was compiled by the clinical audit department.
Results: 84 attempts were made at radial access and 166 attempts at femoral access (77% and 75% complete success respectively). Left and right coronary intubation was achieved in 90% and 84% of cases respectively. Successful haemostasis was achieved in 98% of cases. 99% of coronary angiograms were accurately reported. There were no complications or adverse outcomes. Nurse X ray times and contrast usage were 2.4 mins and 72 mls respectively (vs 5.7 mins and 95 mls for registrar).
Conclusions: Nurse angiography by appropriately supervised senior staff is effective, safe and of high quality. It enhances cathlab productivity and job satisfaction, improving staff retention.