Author(s): Erin LaMaina, RN


Nurse Manager
Good Samaritan University Hospital

I started my career as a registered nurse in a cardiac designated hospital. For over 10 years I worked in Med/Surg and ICU caring for a variety of patients with underlying cardiac comorbidity before transitioning to the Cardiac Cath Lab. I received my Masters in Nursing Education and worked as the Nurse Educator in the Cardiology Department for the last 6 years. I have supported the growth of the department, providing program development and staff education to pre- intra- and post procedure staff for new procedures including TAVR, Cardiac CTA, TCAR, Mitraclip, PFO closure, Micra and Watchman. In addition, developing policies and procedures to insure clinical quality and patient safety. Most recently, I accepted the position as Nurse Manager of interventional cardiology and imaging and support the department with development of performance and quality improvement and patient safety initiatives.

Competency Domain: Patient Safety

Description: The purpose of this project is exploring opportunities for decreasing bleeding post percutaneous coronary intervention with the overall goal to decrease patient length of stay and mortality and increase patient satisfaction and safety. The data documents Good Samaritan University hospital's PCI patient's and bleeding complications over 5 years and the outcome of exploring a multitude of interventions to mitigate the problem.Problem:Bleeding in the post cardiac stent patient leads to increase in length of stay, patient dissatisfaction, and even mortality. Good Samaritan University Hospital started its journey to stopping the bleed above the national average at 7.41%. With initial goals to decrease post PCI bleeding below 3.5%.Measurement:Using the National Cardiovascular Data Registry (NCDR) to abstract PCI bleeding rates, we are able to measure our on-going progress quarterly as all PCIs are entered into the registry system.Analysis:Using a convenience sample, we have been able to obtain data from over 7,000 procedures in the last 5 years to monitor progress.Implementation:Implementation of interventions was done with a multidisciplinary team approach. These included documentation changes, education, product evaluations, bleeding risk score evaluation, ultrasound use f, and radial site access. Physician support and change was one of the biggest obstacles that was encountered in this project.Results/DiscussionThe overall outcome was a reduction in bleeding by over 50%. We to improve our results in the coming year with additional interventions and increased monitoring.

Evaluation: Complete Poster Evaluation