The Heart Center Clinical Services Team is a highly specialized group of nursing and allied health professionals. We are the constant presence for the patient and family during the diagnosis and treatment for heart disease and significantly contribute to excellent outcomes. We also contribute to Nationwide Children’s Hospital status as a leading institution by achieving MagnetTM Designation in 2005, a feat achieved by less than 6% of hospitals nationwide and re-designation in 2009 and 2014 (applied) attained by only 3% percent of hospitals.
There is 24/7 coverage by Advanced Practice Registered Nurses who manage patient care in collaboration with Attending physicians. Nursing care is delivered utilizing nursing ratios dependent on patient acuity. Nurses receive specialized and continuing education for patients from birth to adult in the following areas: pre and post-operative cardiac care, cardiac, and heart and lung transplant. Many staff hold CCRN (Critical Care Registered Nurse) and pediatric certifications. Nursing, respiratory therapists, social workers, patient care assistants, and other allied health professionals provide a variety of specialized clinical services to provide comprehensive patient care and help improve outcomes.
Nursing care is delivered utilizing one nurse to 3-4 patient ratio. Nurses have specialized training and are experts at patient teaching, discharge planning, and assisting patients to resume normal activities. All nurses have advanced life support certification, and over half hold pediatric nursing certification. Nurse practitioners and nurse clinicians ensure continuity of care for patients. In addition, the unit utilizes social workers, patient care assistants, telemetry technicians, respiratory therapists and other allied health professionals to compliment nursing services.
Eight Cardiothoracic OR nurses are dedicated to the cardiac OR’s and provide 24/7 coverage for any cardiac or thoracic surgery. Four of these nurses hold certification as RNFA (first assistants) and directly assist the surgeon at the OR table. Certified registered nurse anesthetists (CRNA) work with the team of dedicated Cardiac Anesthesiologists to induce and maintain anesthesia. There are six Cardiovascular Perfusionists who provide circulatory assistance through management of the heart-lung bypass, extracorporeal membrane oxygenation (ECMO), or ventricular assist device (VAD) machines before, during, or after open-heart surgeries. Together all of the staff provide continuous monitoring to provide and ensure patient safety throughout the procedures. All members of the team complete required documentation and communicate with the Cardiac Intensive Care Unit to prepare for patient transfer.
The Cardiac Catheterization and Electrophysiology (EP) Suites are staffed by Interventional Cardiologists and Electrophysiologists, Advanced Practice Registered Nurses (APRN), certified Registered Nurses (RN), Registered Radiation Technologists (RT), Registered Cardiovascular Invasive Specialists (RCIS), and Certified Electrophysiology Specialists (CEPS). Two of the three Interventional Cardiology Nurse Practitioners APRN hold a PhD degree and independently conduct clinical research. The role of the Interventional Cardiology Nurse Practitioner includes independent management of interventional cardiology patients, cardiac catheterization, first assist for all interventions, as well as experience with innovative technology for transcatheter devices, transcatheter heart valves, and FDA sponsored clinical trials.
The EP APRN is a Clinical Nurse Specialist (CNS) who collaborates with Electrophysiologists to manage patients with heart rhythm abnormalities. The Nurse Practitioners and CNS work collaboratively with the Interventional Cardiologist or Electrophysiologist in the management of all patients with congenital heart disease and/or patients with heart rhythm abnormalities. This includes complete assessment and management, both in-patient and in the out-patient ambulatory setting, as well as patient and family education for all congenital and structural heart disease lesions, and treatment options.
Certified Registered Nurse Anesthetists (CRNA) work in collaboration with a team of dedicated, Heart Center Cardiac Anesthesiologists providing 24/7 coverage for all cardiac catheterization and electrophysiology procedures. The anesthesia team provides sedation or anesthesia, airway management, and continuous monitoring to ensure patient safety and comfort throughout the procedures. Advanced imaging is also performed during select procedures including: 3D Transesophageal Echocardiogram (TEE), Intracardiac Echocardiogram (ICE), Intravascular Ultrasound (IVUS), 3D Rotational Angiography (3DRA), 3D EP mapping. In addition, radiation safety is a major initiative of the Nationwide Children’s Hospital Catheterization and EP services. Fluoroscopy record, dose tracking system, and spot fluoroscopy are all advanced technologies to lower the radiation exposure for all patients and staff that work in the suites.
Together, the entire team provides the highest quality, comprehensive care for interventional cardiac catheterization, and electrophysiology and pacing procedures to all patients with congenital or structural heart disease, regardless of age. Following the procedure, members of the team, at all levels, communicate with the inpatient units to facilitate the transition to the post anesthesia care unit (PACU), cardiology unit (H4A) or to the cardiothoracic intensive care unit (CTICU).
Our nurses are part of a highly valued multidisciplinary team that consists of working with cardiologists, cardiovascular technicians, exercise physiologists, sonographers, registration, and patient care associates. The nurses are involved with triaging, completing assessment and medication reconciliations, and facilitating the needs of the patient and their families.
One of the primary focuses of the clinic nurse is education and teaching. Teaching opportunities in the clinic can come in many different forms. When a patient has an echocardiogram scheduled the nurse can alleviate the patient’s anxiety by explaining the test. Nurses also play a key role when a family has questions about diet and activity for their child that has been newly diagnosed with heart disease.
Advanced practice nurses and nurse clinicians function within the clinic, as well, following different types of patient populations, such as the adult congenital heart disease patients. Nurses are integral in the management and communication for multiple specialty clinics, such as Kawasaki’s disease. The clinic nurses are also involved with outreach clinics that are as close to home as Dublin and as far away as Portsmouth and Findlay, Ohio. These outreach clinics give the nurse the ability to offer the same standard quality of care to the patients as if they were being seen on main campus.
“I have 20 years of experience as a RN and 7 years of experience as an APN. I ensure safe practice as well as education not only to nursing staff but medical staff every day. It is my goal to advocate for advance practice nursing amongst my peers as well as my medical colleagues so that we may develop a safe and effective practice model.”
Michelle Grcic, CNP
Certified Nurse Practitioner
“I ensure safe and efficient day-to-day operations in Heart Center Nursing. I also strive to create a vision to advance nursing practice for the future. It’s not only where we are but where we are going to reach our goal to be the best of the best.”
Amy Biddle, MSN, RN
Director of Clinical Services
“My line of sight is to remove any barriers that may prevent my staff from providing superior care to every patient on H4A by using my own personal ‘5 rights’. I want to make sure that they have the right supplies, at the right times, for the right patients, with the right staff, and the right support.”
Jaime Manley, BSN, RN
Program Manager H4A
“I incorporate my skills as a mother of multiple children and apply them at my job to provide equal and excellent care to children of varied ages and stages in their life.”
Julie Baker, RN
Staff Nurse H4A
“I promote best outcomes in the CTICU by managing daily operations to ensure staff members have the resources, information, and education to provide the highest quality of care to our patients and families. I work collaboratively with multidisciplinary team members to support quality initiatives, enhance patient safety, and improve customer service.”
Sarah Brandt, BSN, CCRN
Clinical Leader CTICU
“I promote best outcomes by ensuring all RN staff complete yearly competencies, attend continuing education and encourage staff to advance their nursing careers”.
Roxann Tyner, MSN, CCRN
Clinical Leader CTICU
“I promote best outcomes by benchmarking our patient data against national data for research and development of best practice models for patient care”.
Catt Dime, RN
Staff Nurse and VPS Coordinator