PCR Goals and Objectives Cardiac Cath by keralaguest

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									               CARDIAC CATHETERIZATION
GOALS AND OBJECTIVES – ORGANIZED BY CORE COMPETENCIES

Background:
Fellow education in the cardiac catheterization lab includes learning the technical aspects of performing a
cardiac catheterization including achieving appropriate anesthesia, obtaining access to blood vessels,
manipulating the catheters to obtain hemodynamic information and using the catheters and imaging
equipment to perform angiography. Other important aspects of the experience include pre-cath
assessment of the patient and obtaining consent as well as post cath reporting of data and data
interpretation for use in clinical decision making. Because of the complex nature of the catheterization
procedure as well as the acuity level of the patients, the care team in the cath lab includes nurses and
technicians as well as the physician staff (which includes cardiologists and anesthesiologists.) For safe
and effective patient care, it is essential that this care team works together in a coordinated and efficient
manner.

The following goals and objectives are applicable for all fellows rotating through the cardiac cath lab:

Goals:
Know how to safely and professionally perform a cardiac catheterization, which includes the ability to:
           Acquire the appropriate hemodynamic data
           Interpret these data
           Communicate these data and the patient’s clinical state and needs to other health care
               professionals
           Coordinate the care for patients who have undergone cardiac catheterization.
           Participate in at least 100 cardiac catheterizations during fellowship

The fellow should expect one-on-one teaching from the attending after each study or at the end of each
day. The fellow will receive informal feedback on a daily basis and formal feedback twice a month.
The YEAR of Training is listed for clinical training in Pediatric Cardiology. In other words, YEAR 1 of
clinical training in Pediatric Cardiology and YEAR 2 of clinical training in Pediatric Cardiology. The
specific objectives for the cath rotation are as listed below:                                                    Communication
                                                   Year of Training




                                                                                                                                   Professionalism


                                                                                                                                                     Systems Based
                                                                                                 Practice Based


                                                                                                                   Interpersonal
                                                                      Patient Care



                                                                                     Knowledge




                                                                                                                       Skills
                                                                                                 Learning




                                                                                                                                                     Practice
                                                                                     Medical




Cardiac Catheterization:
Goal: Know how to safely and professionally perform a cardiac catheterization, which includes the ability
to achieve the following objectives:
    Compose a plan for the procedure by
    performing pre-procedure evaluation
    consisting of history and physical
    examination and review of all past           1       X       X        X
    medical data and past procedure data
    (cines, catheterization reports, ECHO,
    Holter, Treadmill, EKG’s, etc)
    Relate this plan to the catheterization
    laboratory attending prior to the            1       X       X        X        X        X
    procedure
    Safely conduct the procedure by
                                                 1               X        X        X        X         X
    making sure that all pre-procedure
                                                                                                              Communication
                                               Year of Training




                                                                                                                               Professionalism


                                                                                                                                                 Systems Based
                                                                                             Practice Based


                                                                                                               Interpersonal
                                                                  Patient Care



                                                                                 Knowledge




                                                                                                                   Skills
                                                                                             Learning




                                                                                                                                                 Practice
                                                                                 Medical
preparations are in place (e.g., blood
set-up, general anesthesia notified,
PICU/PCICU or recovery room notified,
etc.)
Recognize radiation safety concerns
and cite a basic understanding of                            1    X                X
radiation physics and radiology
Discuss catheterization techniques,
                                                   2              X                X             X                 X              X
devices, and instrumentation
Communicate and provide appropriate
post-procedure care; achieved in part              1              X                X             X                 X              X                  X
by:
 o Writing preliminary procedure note
 o Writing post-procedure orders
 o Relating the results of the study and
      status of the patient to those to whom
      care will be transferred, which will
      include other fellows and the
      residents
 o Monitoring patient recovery
 o Writing follow-up notes in patient
      chart, and formulating discharge
      plans
Recognize the basis of function of the
catheterization laboratory equipment
                                                   1                               X             X                 X
and apply this knowledge to the
performance of the procedure
Perform vessel cannulation and
insertion and removal of catheters
successfully. By the end of the first
three rotations, the fellow will
successfully perform cannulation in                2              X                X             X
over 50% of the patients and by the
end of all the rotations, successfully
cannulate and insert catheters in over
75% of the patients
Relate an understanding of normal and
abnormal physiology and normal and                 1              X                X             X
abnormal anatomy
Characterize the cardiovascular
anatomy of each patient for whom the
                                                   1              X                X             X                 X
fellow participates in their
catheterization
Obtain and begin to synthesize
                                                   1              X                X             X
angiographic and hemodynamic data
Obtain and synthesize all angiographic
                                                   2              X                X             X
and hemodynamic data
Relate pathophysiologic states to the              1              X                X             X                 X              X                  X
                                                                                                          Communication
                                           Year of Training




                                                                                                                           Professionalism


                                                                                                                                             Systems Based
                                                                                         Practice Based


                                                                                                           Interpersonal
                                                              Patient Care



                                                                             Knowledge




                                                                                                               Skills
                                                                                         Learning




                                                                                                                                             Practice
                                                                             Medical
angiographic and hemodynamic data
Communicate important findings and
management changes to other health
                                               1              X                X             X                 X              X                  X
care providers, including referring
physician.
Collaborate effectively with all co-
workers                                        1              X                X             X                 X              X                  X
Complete procedure reports within
three days without being reminded              1              X                X             X                 X              X                  X
Be punctual, courteous and polite at all
times                                          1              X                X             X                 X              X                  X
Utilize medical literature and apply to
patient care                                   1              X                X             X                 X              X                  X
Utilize health system to optimize
patient care                                   1              X                X             X                 X              X                  X
Coordinate care of patients                    1              X                              X                 X              X                  X
Communicate effectively with parents
                                               1              X                X             X                 X              X                  X
and patients

								
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