Invasive Cardiovascular Laboratories (Cath Lab) J2-1
The primary focus of the Invasive Cardiovascular Laboratory is the diagnosis and treatment of adult patients with acquired cardiovascular disease and structural/congenital heart disorders. The majority of our patient population is comprised of patients with:
- Acute coronary syndrome (STEMI and NSTEMI)
- Heart failure
- Structural heart disease (adult valvular and congenital defects)
- Carotid and cerebrovascular disease
- Peripheral arterial disease (lower extremities, renal, subclavian)
The Invasive Cardiovascular Laboratories perform some of the most complex, non-surgical procedures in the world. J2-1 offers state-of-the-art nursing and technical support, assisting the medical team in performing procedures such as:
- Coronary angiography
- Myocardial biopsy
- Percutaneous coronary intervention (PCI - coronary angioplasty, stenting, and atherectomy procedures)
- Hemodynamic studies
- Intravascular ultrasound (IVUS) and optical coherence tomography (OCT)
- Carotid artery stenting
- Peripheral artery angioplasty, stenting, and thrombolysis
- Valvuloplasty, valve repair, and percutaneous aortic valve implant
- Congenital defect closure (atrial septal defect, patent foramen ovale, ventricular septal defect)
- Insertion and operation of LV assist devices (IABP, Tandem Heart, Impella)
Electrophysiology Lab - J2-1 (EP Lab)
The primary focus in the Electrophysiology Lab is to care for patients with electrical conduction problems within the heart. The high acuity patient population we treat is comprised of patients with:
- Supraventricular tachycardia (SVT)
- Ventricular tachycardia (VT)
- Atrial fibrillation/atrial flutter
- Tachy-Brady arrhythmias
- Device infections
The treatment for these patients is to implant or explant a device and/or to perform a cardiac ablation depending on the patient’s medical needs. These procedures are preformed in an OR setting by a team of highly skilled doctors and nurses. Currently, we average 4,000 cases per year and are involved in many research studies and state-of-the-art technology. The EP Lab is a challenging and highly specialized place to work with numerous opportunities for professional and personal growth.
Cardiac Prep/Recovery Unit - J21
The Cardiac Prep/Recovery Unit is a 26-bed unit that cares for pre and post invasive cardiac procedure patients. Services provided by this unit includes patient preparation for invasive Cardiovascular and Electrophysiology procedures and recovery post procedure. This unit, located between the Cardiovascular and Electrophysiology Laboratories provides easy access to both invasive procedure areas. Pre-procedure patients arrive from multiple locations (home, inpatient setting, and hospital transfers). The staff in this unit specializes in fast-paced and short length of stay care necessary for this patient population.
Coronary Intensive Care Unit - J31
The primary focus in the 24-bed Coronary Intensive Care Unit is the adult patient experiencing critical cardiac problems. The majority of our patient population is comprised of patients with:
- Myocardial infarction
- Coronary artery disease requiring percutaneous coronary interventions (PCI) and other interventions
- Chronic heart failure
- Valvular dysfunction
- Aortic aneurysms
Some of the most challenging and complex patients in our unit suffer from cardiogenic shock and cardiomyopathy. In order to effectively treat these problems, J31 offers state-of-the-art intensive care nursing services, including hemodynamic monitoring, intra-aortic balloon pumping, therapeutic intravascular cooling, and left ventricular assist devices, thorough and ongoing physical assessment of patients, pharmacologic intervention, mechanical ventilation and continuous respiratory care, along with continuous renal replacement therapy.
Heart Failure Intensive Care Unit - J32
The primary focus of the 10-bed Heart Failure Specialty Care Unit is the adult patient experiencing heart failure. Most of the patients have a chronic heart failure condition and may be waiting for a heart transplant or are being treated with aggressive intravenous vasopressors, ace inhibitors, and diuretics. Many of the patients in J32 are hemodynamically monitored and may require mechanical ventilation, intra-aortic balloon pump therapy, or left ventricular assist devices. Another patient population is the adolescent or adult patient with pulmonary hypertension, managed with pulmonary artery catheters and intravenous medications.
Cardiovascular Short Stay Unit, Post Anesthesia Care Unit (PACU), Cardiac Accelerated Recovery Unit (CARU) - J33
J33 is a unique multidisciplinary unit which is divided into three sections. It is a fast paced area to work with a high volume of patient turn over. This allows the nursing staff the ability to care for a variety of patient populations which have been treated with cutting edge procedures.
The Cardiovascular Short Stay Unit is a 15-bed outpatient unit which specializes in recovery of patients undergoing cardiac or vascular procedures requiring less than a 23 hour stay. Patients in this unit can be monitored by either bedside or remote cardiac telemetry. The Cardiovascular Short Stay Unit receives its patient population from the Cardiac Cath Lab and also the Electrophysiology Lab.
The Post Anesthesia Care Unit is a six-bed unit which specializes in recovery of patients after thoracic and vascular surgery. These PACU patients do not require an overnight stay in ICU.
The Cardiac Accelerated Recovery Unit is a seven-bed unit which cares for patients undergoing cardiac surgery that are candidates for accelerated recovery. These patients typically transfer to a step-down unit within 23 hours and follow aggressive protocols for accelerated recovery.
Thoracic Surgery Step-Down Unit - J52
J52 is a 24-bed unit caring for a patient population with a wide range of medical conditions from pre-cardiac catheterization, and PTCAS. Electrophysiological studies for arrhythmias, AICD, pacemakers, and unstable angina to post thoracic surgical patients recovering from lobectomies, pneumonectomies, thoracoscopic bilateral lung volume reductions for emphysema and esophagogastrectomies.
Cardiovascular Telemetry Units - J51, J53, J61, J62, and J63
These 24-bed cardiovascular telemetry units specialize in post-open heart, surgical, and ventricular assist device patients. The units are fast-paced and provide excellent opportunities in nursing growth and development with the ability to care for patients undergoing innovative procedures. Patient population includes post heart surgery patients such as:
- Coronary artery bypass surgery
- Minimally invasive and robotic heart surgery
- Ventricular assist devices
- Valve replacement or repair
- Other procedures, such as maze procedure, endarterectomy, aneurysm repair
Other Common Cardiac-Related Admissions:
- Angina/myocardial infraction
- Congestive heart failure
- Arrhythmias, such as supraventricular tachycardia, ventricular tachycardia (VT)
- Permanent pacemaker and defibrillator insertion and removal
Ventricular Assist Devices (VADs) - J51, J53, J62:
- Left ventricular assist devices (LVADs) - an implantable, pulsatile device which serves as the left ventricular function
- Total artificial heart
Nursing on these units provide:
- Patient education - addressing the unique discharge needs for this specific patient population
- Specialized teams to provide optimal delivery of care
- Opportunities for community involvement related to education and training
Cardiovascular and Vascular Surgery Intensive Care Units - J54, J55, J56, J64, J65, and J66
The Cardiovascular and Vascular Surgery Intensive Care Units specialize in the post-operative acute care of patients requiring heart surgery, open and endovascular thoraco and abdominal aneurysm repairs, as well thoracic and other vascular surgical procedures. All post-operative patients come directly from the operating room and are recovered, stabilized, weaned and extubated in these units. The unit accepts complex patients from other facilities that may be have had surgical complications or those needing further evaluation for patients that other facilities may not have considered to be surgical candidates.
The patient population is diverse with complex medical problems that may require IABP therapy, CRRT, and thrombolytic therapy. In addition, J55 provides specialized care to individuals requiring heart transplantation, lung transplantation, and ventricular assist devices, such as HeartMate, Thoratec, Abiomed, and ECMO. Nurse-to-patient ratios are routinely 1:2, highly acute patients are 1:1 until stable.
Since 1994, U.S. News & World Report has named the Miller Family Heart & Vascular Institute at Cleveland Clinic as "the best in the nation"for heart care. The staff, patients, and families are involved in many research studies and innovative technology. These areas are very challenging and provide many opportunities for professional growth.
Cardiology Step-Down Units - J71, J72, and J73
J71, J72, and J73 are cardiovascular step down telemetry monitored units. The three units make up a total of 73 beds: J71-25 beds; J72-24 beds; and J73-24 beds. These fast paced nursing units provide nursing care to a select medical cardiac patient population, which includes:
- Myocardial infarction
- Post cardiac intervention
- Chronic heart failure
- Dysrhythmia management
- Pulmonary hypertension
Vascular Surgery Step-Down Unit - J81
J81 is a 25-bed surgical telemetry unit with private rooms. The patient population is largely individuals with vascular diseases or disorders. Common diagnoses include: acute DVT, extremity ischemia, abdominal aortic aneurysm, and peripheral ulcers.
Most common post-operative patients are those who have undergone thrombolytic therapies, amputations, peripheral bypasses and vascular grafts or stenting.
Comorbidities of these patients often include hypertension, diabetes, renal failure and CAD. Employment on J81offers excellent opportunities for skill and professional development of the nurse. J81 is known as a strong learning environment because of its array of patient types, support of students, new graduates and its wealth of skilled preceptors.
Heart and Lung Transplant Unit - J82
J82 is a 24-bed step-down unit dedicated to the specialized care of the solid organ transplant patients; including heart and lung. This unit also cares for patients waiting for heart transplants on inotropic drips that are too unstable to wait at home. J82 also serves as a cardiac telemetry step down unit for cardiac medical patients.
1921 Suites - J83
The primary focus of this 17-bed unit is exceptional care of Medical/Surgical and Cardiology Step-down patients, including but not limited to: Cardiothoracic, Transplant, Vascular, Orthopaedic, Urology, Colorectal and Spine surgeries. In addition to, Coronary and Electrophysiological interventions. This care is given in a state-of-the-art therapeutic environment by staff specifically trained in all of the clinical care areas, as well as the service of high amenity patients.
For more information about the role of nursing at the Miller Family Heart & Vascular Institute or job opportunities go to the Nursing Institute website.
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