A nurse‐led implantable loop recorder service is safe and cost effective

Abstract

Introduction Implantable loop recorders (ILR) are predominantly implanted by cardiologists in the catheter laboratory. We developed a nurse‐delivered service for the implantation of LINQ (Medtronic; Minnesota) ILRs in the outpatient setting. This study compared the safety and cost‐effectiveness of the introduction of this nurse‐delivered ILR service with contemporaneous physician‐led procedures. Methods Consecutive patients undergoing an ILR at our institution between 1st July 2016 and 4th June 2018 were included. Data were prospectively entered into a computerized database, which was retrospectively analyzed. Results A total of 475 patients underwent ILR implantation, 271 (57%) of these were implanted by physicians in the catheter laboratory and 204 (43%) by nurses in the outpatient setting. Six complications occurred in physician‐implants and two in nurse‐implants (P = .3). Procedural time for physician‐implants (13.4 ± 8.0 minutes) and nurse‐implants (14.2 ± 10.1 minutes) were comparable (P = .98). The procedural cost was estimated as £576.02 for physician‐implants against £279.95 with nurse‐implants, equating to a 57.3% cost reduction. In our center, the total cost of ILR implantation in the catheter laboratory by physicians was £10 513.13 p.a. vs £6661.55 p.a. with a nurse‐delivered model. When overheads for running, cleaning, and maintaining were accounted for, we estimated a saving of £68 685.75 was performed by moving to a nurse‐delivered model for ILR implants. Over 133 catheter laboratory and implanting physician hours were saved and utilized for other more complex procedures. Conclusion ILR implantation in the outpatient setting by suitably trained nurses is safe and leads to significant financial savings.

New-generation miniaturized insertable cardiac monitor with a long sensing vector: Insertion procedure, sensing performance, and home monitoring transmission success in a real-world population

“…The extended sensing vector of ≈70 mm versus <50 mm in other contemporary ICM models yields a larger mean R-wave amplitude in BIOMONITOR III (0.73 mV) than in other ICM modes (≤0.60 mV), which may improve sensing capabilities. 7,[14][15][16] Furthermore, R-wave amplitudes were significantly larger (mean 0.80 vs. 0.62 mV) when the device was inserted along the heart axis J o u r n a l P r e -p r o o f (54.2% of pts) than when it was inserted parasternally (41.3% of pts). Therefore, the insertion parallel to the heart's long axis can be recommended as a first-line solution in clinical practice.…”

Career Considerations in Nurse-Led Traditional Chinese Medicine Clinics: a Two-Center Qualitative Study

“… 3 , 32 Additionally, it creates a stream of additional revenue and profit for hospitals. 33 , 34 An umbrella review, after summarizing a large body of evidence, cautiously provided unbiased results indicating that NLCs offer comparable or superior care to usual care with high levels of patient satisfaction. This is because NLCs reduce patients’ waiting times while maintaining their safety and save healthcare resources and costs.…”

Monitoring and diagnosis of intermittent arrhythmias: evidence-based guidance and role of novel monitoring strategies

“…46,49,56 In an observational study including 540 patients, implant site infection was observed in 1.5%, pain requiring device removal or revision in 1.5%, hypertrophic scar in 0.2% and device malfunction in 0.2%. In addition, Lim et al 57 demonstrated that the Reveal LINQ TM (Medtronic©, Minnesota, USA) could be safely implanted in the outpatient setting by nurses, leading to significant cost reductions compared with physician implants in the electrophysiology laboratory.…”