July Advocacy Update: California Fluoroscopy Guidance

California fluoroscopy regulations were amended in 2019/20 with recognition of all professionals in the cath lab—here's the latest.

The pandemic has brought many changes to the healthcare landscape.  One of the most notable recognitions, however, is the fact that allied health professionals are nimble, can provide ongoing support, and are, indeed, ESSENTIAL!

Nowhere is this more true than in the cardiovascular cath lab.  While there are many roles and functions that are critical for care, cardiovascular professionals are able to provide support across a variety of functions.

ACVP Helped Secure California Fluoroscopy Amendment

California’s Title 17 was amended in 2019/2020 with recognition that all professionals should be able to provide support as directed by the cardiologist. Restrictions preventing full participation have been lifted – especially as it relates to California fluoroscopy.

Cardiovascular professionals are able to move the patient, or, for the purpose of re-centering the equipment to the area of clinical interest, move the equipment as long as they are not actuating the equipment to emit radiation; selecting the technique factors or mode of operation; or moving the c-arm or table while radiation is being emitted

It is worth noting that as long as the operator (cardiologist) maintains the necessary fluoroscopy permit and is making these determinations, the cardiovascular professional is able to support the work appropriately. 

The Alliance of Cardiovascular Professionals supported professionals on the ground in California in securing this important amendment.

Knowledge is Power: Continuing to Advocate on the Ground

Please note—often professionals are impacted by State-level regulations via another party's interpretation or understanding of said regulations. This understanding can be incomplete or out-of-date, causing resolved issues to linger in practice. It is crucial to be equipped with this knowledge and to continue to advocate to ensure that all professionals and administrators understand this amendment.

It may also be important to remember that this amendment may be wrongly misunderstood as a relaxing of regulations due to the COVID-19 pandemic—that is not entirely the case, as this amendment was discussed and secured from 2015 through to 2019, via California Department of Public Health committees, before the COVID-19 pandemic impacted the health workforce. However, the pandemic does continue to illustrate its crucial importance.

Why This Amendment is Crucial, Beyond California Fluoroscopy

It is also always effective to continue to explain the amendment along with its rationales: it was fortunate this amendment was secured in California ahead of the COVID-19 pandemic, when workforce shortages became an even more pressing issue.

There is a workforce shortage EVERYWHERE – it is not any anyone’s interest in restricting professionals from doing work for which they are trained, particularly where there has been no public harm demonstrated by full engagement.  The only way to alleviate shortages that impact both access and quality of care is to recognize the work of all professionals and encourage decision makers to employ professionals to reach the top of their credentials. 

In the case of CVTs, those that are credentialed or educated in formal programs have been trained to perform all roles as directed by a physician in a cath lab. It is important to employ all participants that help ensure the team produces the strongest quality outcomes possible.

Let us know what YOUR hospital is doing and how your institution is complying with the updated regulations.  Should ACVP pursue legislation to fully engage and exempt cardiovascular professionals? 

Please let us know – respond to peggymcelgunn@comcast.net with information regarding what your institution is doing and how it is managing to support all team members in the cath lab!

Benefits of Virtual Continuing Education for Cardiac RNs, Technologists

What are the benefits of virtual continuing education for cardiac RNs and technologists? They're far greater than simply getting necessary CEUs from the comfort of your own home (though, that's great too). We've already seen the energy and activity our first virtual conference generated, and we're excited for the next. ACVP's next virtual CE festival will be Saturday, November 14—we hope you'll join us!

Eighty-two hours per week… That’s the amount of time an average global consumer spent absorbing information—from television, computers, phones, radio, etc.—two years ago in 2018. No doubt that number has since grown, and with the changes brought about by the Covid-19 pandemic, we can expect it to continue to grow as we navigate the necessary physical distance of an increasingly socially connected world.

Now, we have a tendency to paint seemingly excessive figures of screen time and digital connectivity in a negative light – paradoxically decrying the increased isolation of a population lost in its screens, while simultaneously decrying the incessant connectivity of a world where anyone is only a few clicks away.

But as is true of most societal transformations, our current information age has both positive and negative aspects, and as is true of all eras, it will eventually end and be replaced by the next iteration of society – whatever that may be.

Many have speculated that the next iteration will revolve more around experience and automation, and we can already see this starting to happen with the proliferation of apps, platforms, and services which prioritize the interaction of and between users and consumers, over the collection and analysis of data and information as a goal unto itself.

This is especially true in the world of education. From primary school to highly specialized technical programs in healthcare, we are seeing more immersive, synchronous, virtual experiences offering students a chance to learn “hands-on” while remaining physically distant from instructors and peers.

"The fact is, we are living in an era of yet-untapped potential... In the whole of human history, our collective potential has never been greater." The benefits of virtual continuing education for cardiac RNs and technologists. ACVP

The fact is, we are living in an era of yet-untapped potential. As we continue to navigate uncharted virtual waters there is no doubt that many obstacles will be revealed, but so will new solutions, opportunities, and efficiencies.

  • Our ability to create communities of thought has never been greater.
  • Our ability to access those communities has never been greater.
  • Our ability to generate and absorb new information has never been greater.
  • Our ability to learn from the experiences of others has never been greater.
  • Our ability to effectively re-tool learning environments to meet the needs of both students and instructors has never been greater.
  • Our ability to collaborate across cultural, physical, and ideological boundaries has never been greater.

In the whole of human history, our collective potential has never been greater.

So, while it is natural to think about virtual education in terms of screen fatigue, sedentary lifestyles, and physical separation, perhaps a more purposeful view of virtual communication will look at our need, our capabilities, and our goals to understand and act on our potential.

The Alliance of Cardiovascular Professionals is committed to seeing that potential realized each and every day, as we connect students, educators, and professionals across the country with the most up-to-date, relevant, clinical information and education.

Our next conference offering virtual continuing education conference for cardiac RNs and technologists is on November 14, 2020. In addition to the 6.0+ CEUs available to attendees, there will be ample opportunity to interact with professional peers, students, and teachers alike, and tap that spectacular potential.

We hope you’ll join us as we put the potential of virtual connection to good use with ACVP!

Click here to register »

Shorter Hospital Stays with IV Sotalol for AFib: Saturday’s CE Festival Preview

Sotalol delivered intravenously can offer a one-day regimen initiation for adults with atrial fibrillation, resulting in far shorter hospital stays and reducing hospital costs.

AltaThera Pharmaceuticals partnered with the Alliance of Cardiovascular Professionals to share information about their collaboration with the Federal Drug Administration to bring IV Sotalol back to the market and expand its use for this patient population.

The full presentation will be featured as part of Saturday's Virtual Continuing Education Festival, featuring 8.0 contact hours of continuing education for radiologic technologists, registered nurses and cardiovascular technologists.

In this blog, we offer a sneak-preview of AltaThera's presentation and an example of the excellent, cutting edge education offered by ACVP and our partners and volunteers.

3 Days to 1: Shorter Hospital Stays for Adults with A-Fib

Sotalol IV Converts an Inpatient Procedure to an Outpatient Procedure: Shorter Hospital Stays for Adults with A-Fib

Oral sotalol "has been available for over 25 years, and is the second most prescribed antiarrhythmic," says Rachael Durie, PharmD of AltaThera Pharmaceuticals. The drug is indicated for the maintenance of normal sinus rhythm in patients with highly symptomatic atrial fibrillation or flutter. Sotalol is one of only two class III antiarrhythmic drugs, along with Amiodarone, that are offered in both intravenous and oral formulations, and indicated for both atrial and ventricular arrhythmias.

"Where they differ is in their adverse effects," says Durie. "Amiodarone has such long-term toxicity... if the patient does experience toxicity, it could take almost six months for this to be washed out of the system, whereas all of the other oral agents have a half-life of about 12 hours and can easily be washed out in just three days."

But what's the benefit of delivering the antiarrhythmic sotalol via IV? Far shorter hospital stays for these patients, reducing necessary monitoring from three days to one.

A major drawback of the oral formulation is that patients should be initiated for a minimum of three days in a facility that can provide continuous EKG monitoring. "This is due to the pharmacokinetics of oral sotalol," says Durie, as she explains in her continuing education presentation which will air at 11:15AM Eastern on Saturday, September 26.

"Oral medications need to go through something called ADME: Absorption, Distribution, Metabolism and Elimination, and due to that, it takes five half-lives of the drug to reach the Cmax steady state."

This isn't the case with intravenous delivery of sotalol—pharmacokinetic data suggests that sotalol delivered via IV facilitates a one-day initiation of the regimen, which can be continued by the patient, orally, after discharge without three days of in-hospital monitoring.

The clinical and economic benefits are significant, and especially crucial during the on-going COVID-19 crisis, as Durie outlines in her presentation. "Any time you're reducing hospital length of stay, you're reducing the chance of infection—not just during COVID times." Plus, the cost savings are estimated at $3,000 per patient.

AltaThera Pharmaceuticals is a relatively new company focused on improving patient outcomes via this initiation protocol, which Durie explains in greater detail in her presentation. "This is our first and only product," says Durie. "So we are very committed to our company mission: to improve patient outcomes and reduce overall hospital costs."

There's still time to register for our 8 CEU virtual event!

RNs, RTs and all Cardiovascular Technologists (RCIS, RCES and all CCI credentialed professionals included) can earn 8 contact hours of continuing education by attending the Alliance of Cardiovascular Professionals' inaugural Virtual CE Festival Saturday, September 26. Register and attend complete sessions to earn credit—drop-in or drop-out on your schedule, from your home. Plus, pay what you think is fair.

Outstanding doctors and healthcare professionals from Cleveland Clinic in Ohio and Steward Health, St. Elizabeth's Medical Center in Boston, MA will present nine hours of cutting-edge cardiac continuing education from 8AM to 5PM ET on Saturday, September 26 in a livestream format. Access easily from anywhere—no downloads necessary. Chat with other attendees and presenters with LIVE, REAL-TIME Q&A throughout the presentations.

ACVP members, employees at Cleveland Clinic and Steward Health, and current students may all attend and earn CE, FREE! Others may attend for as little as $1!

Register now »

ACVP Announces Virtual Cardiac CE Festivals, Beginning Sept. 26

We've communicated with our network previously about changing the format of our Fall regional meetings to be virtual. We're extremely excited to announce what that format will be: Virtual Cardiac CE Festivals which are accessible to all with pay-what-you-can pricing.

Our Novel 'Broadcast' Format

Two regional host institutions will combine their outstanding faculty to present at least six hours of continuing education sessions on the latest and greatest developments in cardiac care in a single, livestream broadcast, scheduled for Saturday mornings. Attendees will be able to drop in and out of sessions, earning CE credit for any sessions they attend in full and for which they complete evaluations.

This format allows us to bring the same benefits of our in-person regional meetings—a focus on the host institution's innovations, priorities and outstanding faculty and a concentrated, complimentary educational experience delivering a significant number of CE credits to host staff—to the virtual space, while also opening up opportunities for wider participation and networking between organizations and among all cardiovascular professionals.

Sessions will be recorded ahead of time to ensure a professional, uninterrupted experience, but presenters will be available, live, for question and answer throughout the presentation. Text Q&A will be displayed, live, as part of the broadcast, along with live surveys, interactive quizzes and even prize drawings for our live participants.

Free Registration Eligibility, or Pay What's Fair

Registration for our series of virtual cardiac CE festivals will be entirely free for ACVP members and team members from the host institutions whose faculty are leading our sessions. We ask that all others pay what's fair for this educational experience—to cover our application costs for educational credit and support our work in delivering quality, cutting-edge virtual cardiac CE to non-physicians in all cardiology specialties. But to encourage widespread participation from professionals in all stages of their careers, the minimum contribution is only $1 dollar.

Note: only ACVP members will be able to access continuing education sessions for credit following the live event. Contributing $45 dollars via our registration forms and attending any of these live events will entitle our guests to a complimentary YEAR of ACVP membership, an $85 dollar value! This holds for current and non-ACVP members alike.

As always, Registered Nurses (RNs), Radiologic Technologists (RTs) and cardiovascular technologists of all kinds—CVT, RCIS, RCES (and any other professionals credentialed by CCI)—will be eligible to receive continuing education credit. You must register and follow instructions before, during and after the sessions to receive your CE certificate.

ACVP Sept. 26: Virtual Cardiac CE Festival

Our First Virtual Cardiac CE Festival: September 26

Absolutely stellar faculty from Cleveland Clinic in Cleveland, OH and Steward Health's St. Elizabeth's Medical Center in Boston, MA have combined to present our first virtual cardiac CE festival on Saturday, September 26, from 8:00AM ET to 4:00PM ET, with seven full contact hours of credit available for attendees.

While that may be an early start for our friend's on the West Coast, we encourage you to join us when you can, as we'll be broadcasting all day long!

Register now »

More Virtual Cardiac CE Events to Come, Monthly!

Stay tuned for more updates from the Alliance as we confirm more dates and hosts as we strive to present a live broadcast event with at least 6 hours of virtual cardiac CE credits on a monthly basis, going forward.

If you don't receive our emails, ensure you're subscribed to our e-newsletter at this link.

If your institution may be interested in participating and presenting educational sessions for a future event, please reach out to our communications director, Kurt Jensen: kurt@cardioce.org, to open the discussion. There is zero financial cost to our hosts.