Nurse-Made: TAVR Coordinators Shape Role to Enhance Quality Care & Outcomes (Dr. Sandra Lauck)
In the not-so-long-ago early days of transcatheter aortic valve replacement (TAVR), most eyes focused on the physicians who performed the procedures even as behind-the-scenes contributions from nursing also helped make TAVR a success story. Recognition of their value also is raising nursing’s profile in the cardiovascular community.
Learning by doing
When the Centers for Medicare & Medicaid Services (CMS) released its national coverage determination for TAVR in 2012, it specified that programs establish a heart team with cardiovascular surgeons and interventional cardiologists as well as “additional members … such as echocardiographers, imaging specialists, heart failure specialists, cardiac anesthesiologists, intensivists, nurses and social workers.” The agency took its cue from the aptly named PARTNER (Placement of AoRTic TraNscathetER Valve) studies, Edwards Lifesciences’ pivotal clinical trials that followed a heart team concept.
“In the guidelines, it is embedded as the forced collaboration between cardiac surgery and cardiology,” says Sandra Lauck, PhD, RN, clinical nurse specialist in the Transcatheter Heart Valve Program at St. Paul’s Hospital in Vancouver. She participated in first-in-human TAVR cases, then worked as a cath lab nurse at St. Paul’s with John G. Webb, MD. Webb also contributed to the PARTNER trials and continues as a top investigator.
Candace Stuart reports
Dr. Scott MacDonald, Providence Crosstown Clinic