Author(s): Mark Longanilla, RN, BSN, CV-BC
Cath Lab RN - Audie Murphy VA Hospital
With over three years of dedicated experience in cardiac care, I am a seasoned Registered Nurse specializing in catheterization lab operations and critical care. My tenure in the cath lab has endowed me with profound insights into the nuances of cardiac procedures and the critical importance of tailored patient care, especially in managing risks associated with high stakes environments. My expertise is rooted in a deep commitment to evidence-based practices and continuous quality improvement, principles that have guided my leadership in pioneering an LVEDP-guided fluid administration protocol. This initiative has significantly improved patient outcomes and set new standards for personalized care in high-stakes environments. My passion for advancing cardiac care, combined with my firsthand experience in implementing innovative clinical protocols, positions me as a compelling advocate for best practices in cath lab settings. I am eager to share these insights and contribute to the collective knowledge at NAHQ, driving forward the frontiers of healthcare excellence.

Nick Wales, BSN, RN, CV-BC
Cardiac Cath Lab Nurse - Audie L Murphy Veterans Hospital
As a Cath lab nurse, I've developed a specialized understanding of hydration status and Left Ventricular End-Diastolic Pressure (LVEDP) in post-catheterization patients. My direct experience with these critical indicators, coupled with ongoing learning, uniquely qualifies me for educating others. I'm adept at navigating the complexities of fluid management and its effects on cardiac function, a proficiency refined through practical patient care. This expertise, combined with a commitment to current cardiovascular care practices, equips me to share valuable insights with a NAHQ audience. I aim to enhance patient quality of care and outcomes by imparting knowledge on effective hydration management without exacerbation of heart failure symptoms, avoidance of contrast induced acute kidney injury, and maintenance of optimal hemodynamic values relative to LVEDP.

Competency Domain: Performance & Process Improvement

Description: Explore the innovative approach of LVEDP-guided fluid management in preventing contrast-induced nephropathy (CIN) and fluid volume overload among CKD patients in cath labs. This session delves into the genesis, implementation, and outcomes of a pioneering protocol that personalizes hydration strategies based on left ventricular end-diastolic pressure (LVEDP) readings. Learn how this evidence-based practice enhances patient safety, reduces CIN incidents, and sets new standards in patient care. Through real-world examples, discover the transformative potential of integrating precise hemodynamic measurements into clinical decision-making, ensuring optimal hydration and safeguarding the renal health of vulnerable patients. Problem: CKD patients with heart failure face increased risks of contrast-induced nephropathy (CIN) and fluid overload post-catheterization. The lack of universal, hemodynamics-tailored fluid management protocols highlights a pressing need for evidence-based strategies to mitigate these complications and enhance patient care. Measurement: Pre- and post-protocol implementation data were analyzed to measure incidences of CIN and fluid overload, utilizing electronic health records for accuracy and efficiency in evaluation. Analysis: Our analysis utilized statistical comparison of pre- and post-implementation data on CIN and fluid overload incidences, employing standard deviation and variance measures to assess the protocol's impact on patient outcomes within the cath lab setting. Implementation: We initiated the LVEDP-guided protocol by educating our team, adjusting procedural guidelines, and employing real-time hemodynamic data for patient-specific fluid management, fostering interdisciplinary collaboration for improved patient outcomes. Results/Discussion The implementation of the LVEDP-guided fluid management protocol led to a significant reduction in CIN and fluid overload cases, demonstrating its effectiveness in enhancing CKD patient care after catheterization procedures. This approach has proven vital for improving patient outcomes and safety in the cath lab setting.

Evaluation: Complete Poster Evaluation