CARDIAC-CATHETERIZATION PERFORMED BY A CLINICAL NURSE SPECIALIST

Objective-To establish the feasibility and safety of an appropriately trained clinical nurse specialist performing diagnostic cardiac cathet erisation. Design-Non-randomised retrospective comparison between the first 100 and second 100 consecutive investigations by a clinical nurs e specialist and 200 consecutive patients investigated by two cardiolo gy registrars over a similar period. Setting-Regional cardiac centre p erforming 3200 catheterisation procedures per annum. Patients-200 pati ents undergoing routine (non-emergency) cardiac catheterisation for in vestigation of ischaemic heart disease. Main outcome measures-Procedur al complications, image quality, fluoroscopy times. Results-Satisfacto ry diagnostic images in all nurse specialist cases with no deaths and two complications (coronary artery dissection and femoral pseudoaneury sm). Procedure duration and fluoroscopy times slightly shorter for cli nical nurse specialist by 3 and 1.6 minutes, respectively (P < 0.05). Conclusions-Non-medical practitioners can be trained to perform straig htforward cardiac angiography in low risk patients with consultant sup ervision, as for cardiology registrars. With important restrictions su ch posts may have a limited role in supporting future consultant based services.