Hemochron ACT for vascular cases
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I have been asked about using a hemochron for ACT-LR testing in vascular cases, specifically carotids. Does anyone else use hemochrons in OR for vascular cases?
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We use the ACT-LR for our vascular cases in the OR and in IR and during cardiac caths. ACT+ for the open hearts.
Let me know if you have any questions.
Lois Snider
lois.snider@stclair.org
412-942-3827
We use the Hemocrhon Signature Elite for ACT-LR testing in Vascular OR. Interventional Radiology, and Cardiac Cath Labs. It us simple to use and the Providers are happy with it. It is a Moderately Complex Test with all the hoopla that goes along with it, but the staff are very good about maintaining competency.
We use the Hemochron Signature Elite ACT+ for our open heart and vascular surgery. Currently this testing is performed by the Perfusionists and Anesthesiology
Technicians. There is a request to train all the surgery residents on the process to provide coverage late into the night for ACT results every 30 minutes.. How are you handling coverage and who is trained to perform testing?
Steven Lauf
Sr. Technologist Point of Care I Laboratory
St. Joseph’s Health
703 Main Street, Paterson, NJ 07503
Phone:
973.754.3588 I
Fax: 973.754.3292
laufs@sjhmc.org
I www.StJosephsHealth.org
From: Debra Stark via POCT Listserv (Groupsite) [mailto:users+1177361@poct.groupsite.com]
Sent: Wednesday, March 20, 2019 12:53 PM
To: Lauf, Steven
Subject: [POCT Listserv] Re: Hemochron ACT for vascular cases
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We are part of a large 20+ hospital health system and the model we have adopted using Accriva Hemochron Sig Elite devices is identical to above - ACT+ for CVOR/open heart (large heparin dosing) and ACT-LR for everything else (vascular, cath lab, IR).
We have a similar situation here regarding off-hours ACT coverage - not having 24/7 Anesthesia Tech coverage at my particular facility. As a result, we have to rely on Anesthesiologist staff (MDs) as the testers, to keep the trained pool as small as possible. They don't like it, but it's a necessary evil. Fortunately we have about a 10-yr history of this model, so they're pretty used to it, and the group doesn't change out very often.
I won't lie - trying to maintain training and competency for a constantly rotating group of surgical residents sounds like a nightmare. Do you have any other options to maintain service using a more stable group of staff?
In addition to the residents, the Chairman in the OR is requesting a large number of atttendings be trained. I am trying to float the idea of OR Nurses as
a stable group but have not achieved much traction on the idea. The OR Charge Nurse has been appropriately trained.
Steven Lauf
Sr. Technologist Point of Care I Laboratory
St. Joseph’s Health
703 Main Street, Paterson, NJ 07503
Phone:
973.754.3588 I
Fax: 973.754.3292
laufs@sjhmc.org
I www.StJosephsHealth.org
From: James Beck via POCT Listserv (Groupsite) [mailto:users+1173212@poct.groupsite.com]
Sent: Thursday, March 21, 2019 3:15 PM
To: Lauf, Steven
Subject: [POCT Listserv] Re: Hemochron ACT for vascular cases
CAUTION! This email came from outside St Joseph’s Health. Exercise extra caution clicking links and opening attachments from any and all senders.
*** Important Notice About St. Josephs emails ***
St. Josephs Regional Medical Center is using Zix to encrypt any emails containing Protected Health Information (PHI). If you receive an encrypted e-mail from a person at St. Josephs the body of the message will indicate that you have a "New Zixcorp secure email from St. Josephs Regional Medical Center." You will need to click on the link in that email to retrieve the message. For more information please visit http://www.uapguide.com/st-josephs-hospital-and-regional-medical-center/introduction. For help in retrieving a secure email that you have received from St Josephs please go to http://www.uapguide.com/st-josephs-hospital-and-regional-medical-center/receiving-encrypted-email.
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THIS TRANSMISSION IS INTENDED ONLY FOR THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND CONTAINS INFORMATION THAT IS CONFIDENTIAL. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE DELETE THE EMAIL AND CONTACT THE SENDER IMMEDIATELY. THIS INFORMATION MAY HAVE BEEN DISCLOSED TO YOU FROM CONFIDENTIAL RECORDS AND MAY BE PROTECTED BY FEDERAL AND STATE LAW. THIS INFORMATION MAY INCLUDE CONFIDENTIAL MENTAL HEALTH, SUBSTANCE ABUSE, ALCOHOL ABUSE AND/OR HIV-RELATED INFORMATION. FEDERAL AND STATE LAW PROHIBITS YOU FROM MAKING ANY FURTHER DISCLOSURE OF THIS INFORMATION WITHOUT THE SPECIFIC WRITTEN CONSENT OF THE PERSON TO WHOM IT PERTAINS, OR AS OTHERWISE PERMITTED BY LAW. ANY UNAUTHORIZED FURTHER DISCLOSURE IN VIOLATION OF THE LAW MAY RESULT IN A FINE OR JAIL SENTENCE OR BOTH. A GENERAL AUTHORIZATION FOR THE RELEASE OF THIS INFORMATION MAY NOT BE SUFFICIENT AUTHORIZATION FOR FURTHER DISCLOSURE.
My suggestion would be to involve them as much as possible in the training & competency assessment process, including documentation. When they see all that is involved regarding requirements for a moderately complex test, they may rethink the size of the "trained group."
I have a great CRNA director here that I work closely with, so she's intimately involved with the process and what's required and she totally gets it. She realizes the value of having only the necessary people trained and does not support people trained out of convenience, even when that's an unpopular decision. But if she had a distant role in the whole POCT training/competency assessment process, that might not be the case. She might likely just hand down a decision.
Thanks, I was mostly trying to see if the ACT was a standard of care for vascular cases. We already have hemochrons in the cath lab and ACT plus in the heart room, so I am familiar with the test.