Equipment
Nurse Competency
Patient Education
Performance Measures
Documentation
100

When do we clean VAD equipment?

Before AND after patient use.

100

Can a patient travel without an RN to procedure or test when they are in the CCU?

Patients in CCU must be accompanied by a VAD Competent Nurse. 

Patients on the floor only need to be accompanied by a VAD Competent Nurse if they are unable to care for their VAD, are newly implanted and cannot take care of their VAD or receive sedation. 

100

What do patients need to be taught to bring with them when they come to the hospital?

Back up controller and extra set of batteries

100

Where can you find MMC Performance Measures for VAD patients?

LVAD poster on the unit

100

What is the name of the flowsheet for documentation?

Under the VAD flowsheet

200

What is approved cleaner for VAD equipment?

Sani-cloth only.

200

What do you do if you suspect there is a problem with any part of the LVAD?

Call heart success.

200

Who is responsible for anticoagulation teaching? 

Name 3 disciplines. 

Pharmacy

Nursing

Dietary (coumadin diet teaching)

200

How do you know how often to change the VAD dressing and how do you know what type of dressing kit to use?

Frequency of dressing changes will appear as an order in Epic under orders. Type of dressing kit will also be specified (Daily or Weekly dressing kit). 

200

How often are MAPs documented?

As ordered

300

What must we ensure is present with patients with when travelling anywhere? This includes admission, transfer, or procedure.

Back up controller

2 Extra Batteries

2 Extra Clips (HM only)


300

Where are VAD Guidelines located?

There is a VAD resource binder on each VAD competent unit

300

What are the focuses of education for patients and families prior to discharge?

Dressing changes, VAD alarms, and ADLs

300

What are other quality measures that are monitored?

30 day re-admission, GIB, 30-day survival, 90-day survival, stroke within 30 days, infection within 3 months of implant, device malfunction

300

What are the different types of order sets?

Pre/Post Op

LVAD order set

400

How often are equipment carts checked by the VAD team?

Monthly

400

How do you find the MAP of an LVAD patient?

MAP is found using manual BP cuff and doppler

It is a systolic measurement found at either the radial or brachial pulse points with a target of 65-85

400

What should LVAD patients and families for taught as signs and symptoms of driveline infection?

Temperature greater than 38 degrees C, erythema or drainage at insertion site

400

Name all 4 quality measures for our LVAD patients.

1. 1 year readmission rate

2. Out of bed and ambulating within 72 hours of implantation

3. Driveline infection rate

4. Length of stay

400

What are the 3 main components of documentation on the VAD flowsheet?

VAD settings (Flow, speed, PI, power, back up controller, system checks)

Dressing changes

Site assessment

500

How often are system checks done and how are they performed?

Daily for Heartmate 

No system check for HVAD

Hold down the batter button

500

What is the Pulsatility Index?

The measure of estimated LV contractility and how much volume is pumped with each contraction

500

Who leads the education given to patients and families and on what topics?

Heart Success Leads education and RNs reinforce with hands of practice (Batteries/connections/dressing changes/medications).

500

When evaluating program specific performance measures, what is used to compare?

MMC vs. National Average

500

How are many of the VAD orders placed in EPIC?

The VAD order set, in which many orders are placed as Nursing Communications

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