por Gus Iversen
, Editor in Chief | May 05, 2016
The first-ever, evidence-based interventional radiology staffing guidelines have been compiled by the Society of Interventional Radiology (SIR) and published in the May issue of the Journal of Vascular and Interventional Radiology.
The guidelines were derived from a 2014 multi-center survey of SIR members that was aimed at pinpointing the staffing issues that hamper the work of interventional radiologists, particularly during off hours.
That survey revealed the difficulties they faced in obtaining access to anesthesia services and qualified support staff for on-call procedures, as well as a need for admitting privileges.
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The guidelines call for three non-physician health care practitioners — at least one of whom must be a registered nurse — to assist the interventional radiologist in all interventional radiology suites being used. They also call for hospital admitting privileges on par with other admitting physicians, as well as cross-training of non-physician staff to allow for flexible staffing during off hours.
"On-call and weekend staffing are particularly important so that stable care can be provided on a 24/7 basis, especially given that off-hours patients are often more critically ill than patients undergoing scheduled procedures during the day," said Dr. Mark. O. Baerlocher, the lead author of the guidelines and chief of interventional radiology for the Royal Victoria Hospital in Barrie, Ontario.
The eleven recommendations are divided into sections. The first three are "Procedure and Recovery," 4-5 are "IR Suite," 6-9 are "Off Hours (Including On-Call)," and 10-11 are "Special Considerations".
- A general guideline of required nursing complement in the pre-procedure/recovery areas is one nurse to three patients, in addition to the nursing staff complement required in the IR suites.
- When a nurse-to-bed ratio has been determined, this number should be multiplied by a factor of 1.2–1.8 FTEs per staff position to account for staff vacations, sick time, and educational leaves.
- Staffing levels should ideally be optimized by incorporation of staffing needs into a CQI program
- In addition to the interventional radiologist physician, at least three non-physician health care practitioners should be present per IR suite in use. In some complex patient procedures, four nonphysician health care providers may be needed.
- Hospitals must be prepared to accommodate a sudden or unexpected increase in the number of IR cases scheduled for a given day.