When intervention becomes surgery: nursing readiness and decision-making in the hybrid cardiac catheterisation laboratory

The hybrid cardiac catheterisation laboratory represents a major advancement in contemporary interventional cardiology, integrating interventional, surgical and imaging capabilities within a single clinical environment. This setting enables immediate escalation from minimally invasive procedures to open cardiac surgery, enhancing patient safety in high-risk and complex cardiovascular interventions. While technological integration is central to hybrid laboratories, their effectiveness relies heavily on highly skilled nursing teams capable of managing rapid clinical transitions, advanced equipment and complex workflows. Despite the expanding use of hybrid laboratories, the specific nursing demands and competencies required remain insufficiently described in cardiovascular nursing literature.

To describe the nursing role, workflow requirements and clinical readiness necessary to support safe and effective patient care within a hybrid cardiac catheterisation laboratory.

Methods: A structured nursing practice model was developed within a hybrid cardiac catheterisation laboratory. Nursing roles were mapped across the full patient care pathway, encompassing pre-procedural preparation, continuous intra-procedural surveillance, emergency response and post-procedural care. The model emphasises interdisciplinary collaboration, advanced technical competence, rapid clinical assessment and protocol-based nursing decision-making. The nursing workflow supports seamless transition between interventional cardiology and cardiac surgery when required.

The hybrid laboratory nursing model defines expanded nursing responsibilities, including advanced haemodynamic monitoring, management of complex cardiovascular devices, radiation safety, maintenance of sterility across both surgical and interventional fields, and preparedness for emergency conversion to open surgery. Nurses play a central role in the early identification of clinical deterioration, coordination of multidisciplinary teams and safeguarding patient safety during high-risk and time-critical procedures. Structured workflows facilitate timely clinical decision-making, effective team communication and continuity of care within this high-acuity clinical environment.

Hybrid cardiac catheterisation laboratories demand advanced and highly adaptable nursing practice to ensure patient safety and procedural success. Clearly defined nursing roles and structured workflows enhance clinical readiness, support effective multidisciplinary collaboration and reinforce the strategic contribution of cardiovascular nurses in complex interventional environments. This practice framework underpins nursing education, workforce development and the safe, sustainable implementation of hybrid cardiac services.