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St. Michael's Cardiovascular ICU nurses take on new procedure

Toronto, May 28, 2013

By Patricia Favre

Nurse Cara Silva (left) trains her nurse colleague, Liana Okunev (right), on proper technique for SLIC insertion. Nurse Cara Silva (left) trains her nurse colleague, Liana Okunev (right), on proper technique for SLIC insertion. (Photo by Katherine Cooper)

Nurses in the Cardiovascular Intensive Care Unit have taken on a new skill that will support timely patient care.

Many patients in CVICU require the insertion of a single lumen infusion catheter. Until recently, only physicians were authorized to perform the procedure. For patients, this could mean waiting for significant periods of time for an available doctor – and potentially delaying next steps in care.

Cara Silva, a registered nurse in CVICU, identified that nurses are trained in the necessary background skills for the catheter insertion. With the support of nurse practitioner Mary Mustard, CLM Ellen Lewis and CVICU medical director Dr. Mark Kataoka, Silva developed the research and policy statement required to authorize the training of nurses in this procedure.

“Waiting to insert the catheter sometimes meant we were delayed in starting a patient’s medications,” said Silva. “Authorizing nurses for this procedure is improving patient flow, mobility and helping patients leave the ICU sooner. Morbidity and mortality increases the longer a patient is in ICU. The environment can make you feel more sick than you actually are.”

After the new policy went through the hospital’s approvals process, Dr. Kataoka trained Silva on the procedure. In April, she began training the 60 CVICU nurses, with full implementation expected this month.

The single lumen infusion catheter, or SLIC, is often used to replace a more invasive pulmonary artery catheter. According to Mustard, using the SLIC sooner improves quality patient care.

“It’s a less invasive intravenous line that helps patients get out of bed faster,” she said. “This decreases their chances of pneumonia, lung issues or delirium.”

Lewis applauds Silva’s initiative in identifying her patients’ needs.

“As a bedside nurse, she knew this was something her colleagues wanted addressed,” said Lewis. “It’s better for their patients that they’re getting this timely care.”