At the core of Sentara Heart is a team of highly specialized nurses who care for patients in cardiac units throughout the system in both inpatient and outpatient settings. These nurses perform at the highest level of their clinical expertise to support patients who have been through advanced cardiac procedures.
Under the direction of a cardiologist, cardiac nurses help treat patients with conditions such as unstable angina, cardiomyopathy, coronary artery disease, congestive heart failure, myocardial infarction and cardiac dysrhythmia.
They possess specialized skills including electrocardiogram monitoring, defibrillation, and medication administration by continuous intravenous drip, and are certified in both basic life support and advanced cardiac life support.
The exemplary nursing care provided to every cardiac patient within Sentara’s 12 hospitals plays a pivotal part in Sentara Heart’s continual recognition as a national leader in cardiology and heart surgery programs. While leadership has continued their investment in updated technology to provide evidence-based, highly advanced care to all patients, it is the cardiac nurse who has mastered the required skills to complement the physicians and other members of the healthcare team to ensure that the application and monitoring of all technology is done safely to achieve the desired outcomes.
Advanced Practice Clinicians
With Sentara Heart’s focus on collaborative and multidisciplinary care, advanced practice clinicians (APC) are critical members of a team-based approach throughout our integrated hospital, clinic and physician practice network of heart care.
Our APC team—which includes nurse practitioners and physician assistants—serves as functional owners and clinical leaders to the system wide heart program at Sentara Heart. The platform of this model is high efficiency, high quality and focused patient-centric care. Deliverables are obtained through clinician expertise in both medical and holistic patient care management. The APC team works collaboratively with all physician sub-specialties in a heart team approach in both hospital and ambulatory settings. This ensures that evidence-based best practices are provided to our patients and families. Some of the complex services the APC team provide, include:
- Coordination of care through ambulatory clinic and physician practice sites
- Assistance with advanced structural heart procedures (i.e. TAVR, MitraClip®, Watchman™)
- Cardiothoracic surgery program support at multiple sites
- Assistance with complex catheter ablations in electrophysiology and catheterization labs
- Management of advanced heart failure patients (i.e. VADs, heart transplants, pulmonary hypertension)
- Support for a range of bedside procedures as part of rounding responsibilities
Sentara Heart is committed to providing an environment which enables our APC team to operate at the highest percentile of their licensure. This unique focus and integration within the multidisciplinary heart teams has resulted in quality outcomes and inquiries from healthcare facilities outside Sentara by sharing of best practices.
Recent Areas of Focus and Change
High Reliability Organization:
In 2013, Sentara Heart made a commitment to change the organization’s culture to be more reflective of a High Reliability Organization (HRO). Sentara Heart’s cardiac nurses piloted this initiative. They recognized that Sentara already had all of the tools needed to initiate and sustain this change, most notably behavior-based safety habits, medical response teams, daily safety huddles, and patient-centric care.
The clinical staff worked diligently to promote the four pillars of an HRO culture: accountability, leadership, safety and patient-centric care. Staff then applied the HRO principles to three targeted safety components that greatly impact clinical care: out-of-unit codes, catheter-associated urinary tract infections, and inpatient falls with injuries.
By 2015, the staff noted remarkable results at Sentara Heart, and is looking to expand the HRO program to other Sentara hospital locations. HRO program results at Sentara Heart as of October 2015 reflect decreases in:
- Out-of-unit codes: 6 in 2015 vs. 20 in 2014
- Catheter-associated urinary tract infections: 6 in 2015 vs. 12 in 2014
- Inpatient falls with injury: 11 in 2015 vs. 16 in 2014
Many cardiac nurses are taking the next step into furthering their educations with advanced certifications or degrees, including doctoral degrees, in various subspecialties. Sentara Heart continues to promote continuing education among all nurses in an effort to transform the care delivery model. Highly specialized cardiac nurses bring a significant amount of intellectual capital to the evidence-based care they provide every day.
Partners in Research:
Since 2011, Sentara Heart has encouraged front-line nurses to participate in research and quality improvement initiatives by creating a culture of inquiry and providing logistic support. Every Friday, researchers from the Sentara Cardiovascular Research Institute host a Cardiac Journal Club where nurses brainstorm possible research or quality improvement projects with experienced researchers. The number of nurse-driven quality improvement projects at Sentara Heart has increased steadily each year. In 2015, there were 32 Sentara Heart presentations, 22 involving cardiac nurses.
Exceptional Patient Care:
The formalized cardiac committees at Sentara Heart serve as a great platform for the cardiac nurses. While there are various types of cardiac nurses working in multiple settings, there are several standardized approaches to cardiac care that are constant among all sites. Consistency is key and remains a strong theme among the cardiac nurses. Each nurse understands the importance of providing the best care as cost efficiently as possible. It is for this reason that the cardiac team is always looking for collaboration for group purchasing.
The outcome of applying these principles to the care delivery model, and adhering to the Sentara Commitments to Cardiac Nursing Care, is reflected in our customer service scores. These scores reflect a rolling 12 months’ percentile ranking of 96 percent. On a scale of 10 (best hospital) to 0 (worst hospital), 86 percent of patients rate their overall care at Sentara at a 9 or 10.
The Sentara Heart cardiac nurse embodies the Sentara Philosophy of Nursing as evidenced by the treatment provided to patients suffering from heart conditions. Each patient requires a unique and individualized treatment approach. The Sentara Heart nurse delivers a hallmark standard of care that serves as a role model for other heart centers nationwide to emulate.