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    Integrated Cath Lab Safety Checklist

    Uploaded by

    wenhal
    This document provides a checklist for procedures done in a cardiac catheterization laboratory. It includes sections for checking patient details and preparation, the procedure plan, equipment, and post-procedure handover. The checklist aims to ensure patient and procedure safety and coordination of the catheterization laboratory team.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Integrated Cath Lab Safety Checklist

    Uploaded by

    wenhal
    776 views2 pages
    This document provides a checklist for procedures done in a cardiac catheterization laboratory. It includes sections for checking patient details and preparation, the procedure plan, equipment, and post-procedure handover. The checklist aims to ensure patient and procedure safety and coordination of the catheterization laboratory team.

    Original Description:

    Integrated Cath Lab Safety Checklist

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    This document provides a checklist for procedures done in a cardiac catheterization laboratory. It includes sections for checking patient details and preparation, the procedure plan, equipment, and post-procedure handover. The checklist aims to ensure patient and procedure safety and coordination of the catheterization laboratory team.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    776 views2 pages

    Integrated Cath Lab Safety Checklist

    Uploaded by

    wenhal
    This document provides a checklist for procedures done in a cardiac catheterization laboratory. It includes sections for checking patient details and preparation, the procedure plan, equipment, and post-procedure handover. The checklist aims to ensure patient and procedure safety and coordination of the catheterization laboratory team.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    British

    Cardiovascular
    Society

    British
    Cardiovascular
    Society

    WA R D C H E C K L I S T

    C ATH ETER LA BO RATO RY C H ECKLIST

    PATIENT PREPARATION

    CHECKLIST

    Patient details
    PATIENT
    DETAILS

    PATIENT CHECKS

    Patient weight?

    AFFIX STICKER

    kg

    Procedure explained?

    Yes

    Consent form completed?

    Yes
    No

    Consent form completed?

    Yes

    IV access established & checked?

    Wristband/labels/records verbally crosschecked with patient?

    Hearing aid?
    Dentures?
    Jewellery?

    Yes

    NOTES

    & left with patient


    & left with patient

    No
    Yes

    & left with patient

    No
    Yes

    taped / removed

    No
    Yes

    Yes
    No
    N/A

    NOTES

    NOTES

    ___ | ___ | ___

    Other

    ___ | ___ | ___

    at

    (day:month:year)

    ____ : ____

    at

    (day:month:year)

    ____ : ____

    Insert additional question here if required

    Yes
    No
    N/A

    NOTES

    If yes, record BM in bloods box below

    Is O2 required?

    No
    Yes
    No
    Yes

    NOTES

    Known infection risk?

    No
    Yes

    NOTES

    MRSA swab

    Negative
    Positive

    (day:month:year)

    Insert additional question here if required


    Yes
    No
    N/A

    NOTES

    NOTES

    (day:month:year)

    at

    ___ | ___ | ___

    Team members (& visitors) identified by name and role?

    (day:month:year)

    at

    ____ : ___

    Insert additional question here if required

    NOTES

    NOTES

    HR

    BP

    Sats

    Has sedative pre-medication been given?

    No
    Yes

    RR
    Drug
    Route

    IV access established & checked?

    Yes

    No (to be done in lab)


    N/A

    Patient shaved at expected access site(s)?

    Yes
    N/A

    Dose
    PO

    IV

    mg

    Time given

    Yes
    No

    Anticoagulation reviewed?
    Yes
    No

    Any metal plates, pins, or joint replacements?


    Yes
    No

    Yes
    No

    Insert additional question here if required


    Yes
    No

    Yes
    No
    N/A

    NOTES

    Yes

    Yes
    No

    Yes
    No

    Bloods reviewed?

    Yes

    IV access / operative sites identified?

    Yes

    Insert additional question here if required


    Yes
    No
    N/A

    NOTES

    POST-PROCEDURE CHECKS

    PRIOR TO TRANSFER TO LAB


    Baseline vital signs

    Antibiotic prophylaxis given?

    NOTES

    Specific risks or equipment requirements identified?

    No
    Yes

    Yes
    No
    N/A

    NOTES

    Yes
    No
    N/A

    NOTES
    Yes
    No

    Case & planned procedure outlined?

    Yes
    N/A

    Metformin?

    Pacing dependent?

    TEAM BRIEF

    ____ : ____

    Clotting checked and recorded below?

    Last taken

    LOCATION

    No
    Yes

    ___ | ___ | ___

    Yes
    No

    Previous imaging available?

    Drug
    Last taken

    Yes
    No
    N/A

    ACS: ECG changes?

    GRAFT DETAILS

    Is the patient on

    Oral anticoagulation?

    Yes
    No
    N/A

    NOTES

    Previous CABG?

    DRUGS

    Diabetes?

    Insert additional question here if required

    Pacing / Device & Electrophysiology

    Contraindication to drug-eluting stents?

    Last oral intake

    COMORBIDITIES

    ___ | ___ | ___

    Antiplatelet loading dose given?

    N/A (male sex or > 55 years)


    Not pregnant - LMP history
    Not pregnant - test done

    Clear fluids

    Yes
    No
    N/A

    NOTES

    PCI
    No
    Yes

    Pregnancy status checked?


    No
    Yes

    Insert additional question here if required

    Performed on

    Yes
    Yes
    Not required

    Insert additional question here if required

    PRE-PROCEDURE CHECKS

    Previous contrast reaction?

    Glasses or contact lenses?

    SAFETY

    Yes

    No
    Yes

    NOTES

    Yes

    Clinical records available?

    Known allergy?

    Does the patient have

    CARDIOOLOGY

    Patient identity verbally confirmed & wristband checked?

    ____ : ____

    Insert additional question here if required

    Procedure documented on patient record?

    Yes

    Equipment checks, sharps & swab count completed?

    Yes
    No

    Implanted devices recorded?

    Yes
    N/A

    Insert additional question here if required

    Yes
    No
    N/A

    NOTES

    Insert additional question here if required

    Yes
    No
    N/A

    NOTES

    Any equipment problems identified?


    NOTES

    Post-procedure handover to nursing team complete?

    Yes
    No
    Yes

    Insert additional question here if required

    Yes
    No
    N/A

    NOTES

    Yes
    No
    N/A

    NOTES

    BLOODS
    Hb

    PLT

    Checklist completed by

    INR

    eGFR

    Signed

    BM (if indicated)

    Date

    ___ | ___ | ___

    Checklist completed by

    Signed

    Date

    ___ | ___ | ___

    v1.0 2014 Tom Cahill & Rod Stables

    TEAM MEMBERS
    Consultant
    Specialist Registrar

    Non-scrub Nurse
    Cardiac Physiologist
    Radiographer
    Other
    Other
    Other

    AIDE-MMOIRE FOR TEAM BRIEF

    Team brief completed on

    T eam present
    I ntroductions by name and role
    P rocedure outlined, with specific risks & equipment requirements
    B loods reviewed
    I ntravenous and operative access sites reviewed
    G roup concerns?
    ___ | ___ | ___

    at

    ____ : ____

    NOTES

    SAFETY

    SAFETY

    TIP BIG

    British Cardiovascular Society

    CARDIOOLOGY

    CHECKLIST

    Scrub Nurse

    Integrated Safety Checklist

    GENERAL ANAESTHETIC APPENDIX


    Is the anaesthetic machine check complete?

    Yes

    Is there a risk of difficult airway or aspiration?


    NOTES

    Yes
    No

    What is the patients ASA grade?

    Insert additional question here if required


    NOTES

    Insert additional question here if required


    NOTES

    Are there any patient-specific anaesthetic concerns?


    NOTES
    Is the correct monitoring equipment available?

    Yes
    No
    Yes

    Insert additional question here if required


    NOTES

    Yes
    No
    N/A
    Yes
    No
    N/A
    Yes
    No
    N/A

    CHECKLIST

    CARDIOLOGY

    Cardiac Catheterisation Laboratory

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