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special supplement to the

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Shown Here: The Emergency Department at Chester County Hospital in West Chester.

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Luck ucky to be alive live

O

n the morning of November 30, 2012, 62-year-old Russell Wambold of West Grove walked into the Emergency Department at Chester County Hospital barely alive. A longtime sufferer of coronary artery disease, Russell was in cardiogenic shock — his heart was failing, his blood pressure was bottoming out and he was diagnosed with a ST-elevated myocardial infarction. “I walked into the Emergency Department and then went down,” Russell recalls. “Someone was there to catch me and that’s the last thing I remember.” Russell ignored the medical recommendation to call 911 when experiencing chest pain and instead had his wife drive him from his home in Southern Chester County to Chester County Hospital in West Chester. He had been experiencing chest discomfort leading up to this event. An avid outdoorsman, Russell just wanted to get through the upcoming holiday season before going to his cardiologist. Having had previous stents, he was certain he was going to need another intervention. But during a turkey hunting trip the third weekend in November — cut short by intense angina and chest pain — Russell became keenly aware that he wasn’t going to make it to the holidays. “I was in deep trouble,” Russell recalls, “and I knew it.” After being rushed to the catheterization laboratory, Russell’s clinical team, led by his physician, Interventional Cardiologist Timothy Boyek, M.D., discovered that he had a 100 percent blockage of the circumflex artery. After successfully inserting two stents to address the blockage, Russell’s condition was not improving as expected. “Once the artery is opened and blood flow is reestablished, the majority of patients will begin to get better in minutes,” Dr. Boyek notes. “The fact that Russell was not improving prompted us to do a transesophageal echocardiogram which confirmed that Russell’s mitral valve had ruptured.” With three severely diseased coronary arteries and mitral regurgita-

Sunday, February 9, 2014

Chest Pain Center with PCI Re-Accreditation

A longtime sufferer of coronary artery disease, 62-year-old Russell Wambold of West Grove showed up at Chester County Hospital in cardiogenic shock — his heart was failing, his blood pressure was bottoming out and he was diagnosed with a STelevated myocardial infarction.

Timothy Boyek, M.D.

tion, Russell was intubated, placed on a balloon pump, and was rushed to the cardiovascular operating room (CVOR) clinging to life. The CVOR team — led by cardiothoracic surgeon Brian Priest, M.D. and Jenny Dexter, PA-C — quickly mobilized. With his pulse rate dropping, Russell became acutely hypotensive. As Dr. Priest scrubbed in, the CVOR team administered CPR as they readied Russell for surgery with a betadine prep, drapes and cannulation. After eight hours of surgery, Russell had three valves repaired and a new mechanical mitral valve inserted.

Brian Priest, M.D.

Remarkably, Russell was discharged from the Hospital in nine days. Six days later, Russell walked into the Hospital again — this time for his post-operative check-up. “I am lucky to be alive,” Russell says, shaking his head. “No one expected me to make it.” When reflecting on his good fortune he adds, “Chester County Hospital has been great to me. Dr. Priest is an outstanding surgeon and was available to speak with my family at any time. I can’t say enough about the CVU and my critical care team. I wouldn’t trade any of them.”

Chester County Hospital received full re-accreditation as a Chest Pain Center with PCI from the Society of Chest Pain Centers (SCPC). While Chester County Hospital has steadfastly provided superior care to people experiencing chest pain, it is an honor for the Society of Chest Pain Centers to again recognize the hospital’s process for quality and the positive impact this has had on the community. Its Chest Pain Center has demonstrated its expertise and commitment to quality patient care by meeting or exceeding a wide set of stringent criteria and undergoing an onsite review by a team of SCPC’s accreditation review specialists.

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Be Prepared in an Emergency

Hands-Only CPR is a lifesaver If someone suddenly collapsed right in front of you, would you know what to do? Probably, the answer is “no.” Or possibly, “maybe, but I don’t want to do mouthto-mouth breathing.” Many of us have had CPR training in the

who suffer an out-ofhospital sudden cardiac arrest die because they don’t receive immediate CPR from someone on the scene. The benefit of Hands-Only CPR is that it eliminates the fear of forgetting the steps and the reservation of doing mouth-to-mouth breathing. You might wonder how

Department received a grant to purchase American Heart Association CPR Anytime training kits to share with community members wishing to be trained and willing to train others. A member of Community Education will come to your group or business and provide training in doing Hands-Only CPR

past, but in an emergent situation we forget the details about how many breaths, how many compressions, and for how long. Realizing this, the American Heart Association has developed a new training program called Hands-Only CPR. This program only involves two simple steps: (1) Call 9-1-1 (2) Push hard and fast in the center of the chest. That’s it, two simple steps to save a life. It is recommended for use by people who see a teen or an adult suddenly collapse in an “out-ofhospital” setting such as at work, home or a public place. An unfortunate fact is that 89% of people

Hands-Only CPR, without the breathing, can be helpful. Recent research has found that when a person suddenly collapses his or her lungs and blood contain enough oxygen to keep vital organs healthy for the first few minutes as long as someone provides high-quality chest compressions with minimal interruption to pump blood to the heart and brain. Chester County Hospital has an exciting opportunity for people who want to be prepared to do Hands-Only CPR if needed. As part of the Pennsylvania Heart Rescue Project, the Hospital ‘s Community Health Education

as well as education on recognizing the earliest signs and symptoms of an impending heart attack. After the training, the kit, which includes a learning manikin, a CPR skills practice DVD, supplies and an instruction booklet, is left behind for ongoing practice and sharing with others. It is the perfect way to ensure everyone is upto-date and confident to act fast in the case of an emergency. To learn more about arranging for training and acquiring a kit, call 610.738.2300. And, don’t delay. When a heart attack happens, minutes count! Call 9-1-1 immediately!

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Minutes Count!

Know the early heart attack signs

Sunday, February 9, 2014

It can happen

to anyone…

I

A glimpse inside a paramedic’s response to a cardiac arrest call

By Adrianne Pohar Paramedic, Medic 91

By Ralph Smith RN, BSN, Chest Pain Center and Cardiovascular Data Coordinator

H

eart attack is the number one killer of the adult population in the United States, accounting for about 600,000 deaths in 2010 (National Vital Statistics Report, May 8, 2013). Did you know heart attacks have beginnings, and in many cases there are steps that can be taken to prevent a major heart attack from occurring? In more than 50% of heart attack cases, patients experience early tell-tale symptoms. When these

symptoms arise, action can be taken to halt the attack and prevent damage to the heart. These warning symptoms include mild chest pain or discomfort or intermittent pain or discomfort, shortness of breath, back pain, jaw pain, pain in one or both arms unrelated to injury, unusual anxiety or extreme out of proportion fatigue. This early stage of a heart attack is known as the prodromal stage. Symptoms can occur hours or weeks before the actual heart attack. In today’s lifestyle, it is hard to stop and listen to what our bodies are telling us. But if we did, it is possible to decrease the heart attack death of

more than 310,000 people. Since these mild symptoms are easily ignored or easy to shrug-off as indigestion or something other than heart disease, they do not receive the attention they deserve. Denial and procrastination are usual cause for delay. A heart attack is also known as an acute myocardial infarct or AMI. AMIs occur when blood flow in one of the three arteries of the heart becomes blocked or significantly reduced. If the flow of blood is not restored quickly enough, the blocked-off section of heart muscle becomes damaged from lack of oxygen Please see SIGNS on A5

t was November 21, 2012. I was having a good day at work. A few students from St. Lucia had joined me for the day and were excited to witness our advancements in pre-hospital medicine. In St. Lucia, treatment in a pre-hospital setting is limited and the need for advancement exists. We were standing outside ChesChristopher “Goody” Good ter County Hospital by the medic unit when my pager went off. It was a 911 call for a cardiac arrest. This would be the first cardiac arrest call that the students would experience on their visit to the States. For me, I couldn’t even tell you how many cardiac arrest calls I have responded to — except to say that it has been too many. We arrived on scene. The patient was a 36-year-old male. After rushing into the home and to the second floor, I encountered a firefighter on his knees administering Cardiopulmonary Resuscitation (CPR) to the young man. I thought to myself, “Wow, they got here fast!” As I looked down, I realized that I recognized the firefighter doing CPR. He looked up at me and said, “It’s Goody.” After a moment I realized what he had said. It was one of our own. It was a friend, a firefighter, one of our brothers in service. We desperately worked together with an amazing display of teamwork to restore Goody’s heart rate. But when we arrived at the hospital we learned it was too late. It’s not happening this time... The next thing I heard was “Time of death is…” As I recount this day in the field, my eyes fill with tears. I know, if only Goody would have asked for help, if only he would have spoken up when he started to have the symptoms, he could have been saved. He could have been one of those success stories. Goody was a selfless person who ran into buildings when everyone else was running out. He was a hero to many in our community as a captain at Good Will Fire Company in West Chester. I only wish, that day, that we could have been his hero. Heart disease is the leading cause of death in firefighters. And, it is the leading cause of death in America. Everyone needs to be aware of the early signs of a heart attack. Don’t ignore the signs and symptoms. And if you experience them, call 911 immediately! One quick call, and a timely response to your symptoms can save your life.

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Heart Month Wellness Activities Hands-Only CPR Training (FREE) Most Americans feel helpless during a cardiac emergency. Would you know what to do if you saw someone suddenly collapse? Increase your confidence by being trained in Hands-Only CPR (Cardiopulmonary Resuscitation) or CPR without mouth-tomouth breathing. This easy and effective technique, used when an adult suddenly collapses, encourages by-standers, trained or untrained, to do something. Presented in conjunction with area fire companies and CPR Instructors, 45-minute interactive sessions are repeated throughout the program. Date/Time: Feb. 11, 4:30 pm - 7 pm Location: Longwood Fire Company 1001 E. Baltimore Pike, Kennett Square Date/Time: Feb. 12, 4:30 pm - 7 pm Location: Goshen Fire Company, 1299 Boot Rd., West Chester Date/Time: Feb. 12, 4:30 pm - 7 pm Location: Minquas Fire Company, 141 Wallace Ave., Downingtown Date/Time: Feb. 13, 4:30 pm - 7 pm Location: Chester County Hospital, Mira Conference Rm., 701 E. Marshall St., West Chester

Signs gency medical technicians can quickly identify a From A4 heart attack and transport you quickly to the hospital as they begin treatment. and begins to die. This blockage may be caused Once at the hospital, an emergency percutaneous by a blood clot stuck in coronary intervention can an artery or a thickening inside the artery wall be performed to open the blocked artery or arterthat restricts the flow of ies. The team at Chester blood enough to cause County Hospital works pain and damage. hard to triage patients Most of the damage is done in the first two quickly through the syshours of a heart attack. As tem to coronary interventime progresses, so does tion. They perform this the damage to the heart process better than the muscle. This damage is national average. This irreversible and the heart speed saves time, heart may become weakened muscle, and lives. and unable to pump blood Whether it is you or a adequately through the friend or family member experiencing these subtle body. symptoms, remember So, if you believe that you are having a heart at- now is the time to act! If tack, it is of utmost impor- you are thinking about tance that you not hesitate whether or not to call to call 911. Do not drive 911 - CALL 911. It could make the difference beyourself to the hospital! The paramedics and emer- tween life and death.

Living with Type 2 Diabetes (FREE) Don’t let what you don’t know about diabetes keep you from feeling your best. Whether you are newly diagnosed, or have had diabetes for a while, this FREE program will get you up to date with the tools and resources you need to live well with diabetes. Date/Time: Feb. 18, 6 pm - 7 pm Location: Community Wellness Classroom, 600 E. Marshall St., Suite 302, West Chester Turn Your Health Around Simple changes can make a huge difference in managing blood pressure, cholesterol or weight which can directly impact a person’s risk for developing heart disease, diabetes and cancer. Come learn about the small changes you can make. Includes light breakfast. Presenters: Susan Pizzi, RN & Kim Knipe, Registered Dietitian Date/Time: Feb. 22, 9:30 am – Noon Location: Chester County Hospital, Board Room 701 East Marshall Street, West Chester Fee: $7

Speakers Bureau If you are in search of a dynamic speaker to address a specific healthcare topic at your next community program, meeting or event, we can help! Chester County Hospital offers a panel of healthcare providers and wellness educators who are available to provide your group information and education on a variety of current healthcare topics. Our Speaker’s Bureau is a FREE service designed to meet the interests of community groups and organizations. The format of your presentation can be flexible ranging from a formal lecture presentation with question and answers to a more informal/interactive program. Topics that can be covered include a wide array of specialties. To learn more about Chester County Hospital’s Speakers Bureau, visit ChesterCountyHospital.org/wellness.

To register, or for more information about these programs, please call 610.738.2300 or visit ChesterCountyHospital.org/wellness

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Catheterization Transformation

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A small artery in the wrist is making a big impact on heart patients

he human heart is a mighty wonder. Weighing under a pound, it pumps away, moving 2,000 gallons of blood each day and delivering lifesustaining oxygen to every inch of the body, including its own muscle. Like all organs, the heart needs blood to stay on the job. But, heart vessels may be narrowed by plaque buildup, and if a plaque suddenly ruptures and a clot forms (as occurs in a heart attack), a vessel may be blocked. In these situations, chest symptoms and findings on heart tests often lead cardiologists to perform heart catheterization. During the procedure, a thin tube is inserted into an artery in the groin or arm, and a catheter is threaded up the artery to the heart. Dye is injected so blood flow through the heart can be seen on an X-ray (angiography). If one or more coronary arteries is badly blocked and unreachable, the cardiologist may proceed directly to an intervention to restore blood flow, the most common being balloon angioplasty and stent placement. Restoring blood flow can relieve chest pain and other symptoms of coronary artery disease and, most importantly, can save a life or substantial heart muscle during a heart attack.

Taking a shorter route to the heart

Since late 2010, the interventional cardiologists at The Chester County Hospital have been taking a shorter path to the heart during catheter-based procedures. Rather than the standard route through a large artery in the groin, they are using a small artery in the wrist as the entry point whenever possible — a technique called “radial artery access” or Transradial Access.

trend is changing as research increasingly shows that the wrist approach is associated with fewer complications and a better patient experience. Achieving better outcomes and higher patient satisfaction with cardiac catheterization procedures were major goals driving the Hospital’s commitment to offer radial artery access. “Safety was the overriding issue — we saw that it was definitely safer to take the radial approach,” says Interventional Cardiologist Joseph Lewis, MD, who is Medical Director for the Hospital’s Interventional Peripheral Vascular Laboratory and a partner at Chester County Cardiology Associates. “But, it also is more comfortable and convenient for the patient,” he adds.

Since late 2010, the interventional cardiologists at The Chester County Hospital have been taking a shorter path to the heart during catheter-based procedures. Rather than the standard route through a large artery in the Potential benefits to groin, they are using a small artery in the wrist as the entry point whenever the wrist approach possible — a technique called “radial artery access” or Transradial Access. Serious heart complications are Although in existence for 20 years, uncommon with cardiac catheterizathe wrist technique was not embraced tion, but major bleeding at the site in the United States until recently. That where a catheter is inserted is an

important preventable problem. Studies link major bleeding with higher rates of death, heart attack and stroke in the 30 days after a cardiac intervention. The risk of bleeding is higher when the femoral artery in the groin is used and when more medicines are prescribed to prevent clotting. Elderly patients, particularly women with a small frame or low body weight, also have a higher risk of bleeding. “Bleeding is a dangerous complication we need to avoid if at all possible,” says Interventional Cardiologist Mian Jan, MD, Chairman of the Hospital’s Department of Medicine, President of West Chester Cardiology and President of the Chester County Medical Society. He notes that a key benefit of the radial approach is a low potential for bleeding. This was clearly shown in a recent international study in more than 7,000 patients undergoing cardiac interventions to restore blood flow to badly clogged heart vessels. The study, called RIVAL, compared the outcomes of taking a wrist versus groin approach and found

that the wrist approach reduced the risk of major vascular access complications by 63%. Why is bleeding risk lower? For one, says Dr. Jan, the radial artery — which is the artery pressed when taking a pulse — is easy to see and to compress because it sits on top of a bone. Therefore, bleeding from the radial artery is easier to control than bleeding from the femoral artery, which lies deeper in the body and is more difficult to compress. Furthermore, adds Dr. Jan, with the femoral artery, bleeding can occur deep inside the abdomen. “This is the most dangerous of all bleeding,” he says. Dr. Lewis agrees. “With the wrist, there is nowhere for blood to hide,” he says. “If you are not getting adequate compression, you are going to know it immediately, not after a patient has lost a lot of blood.” After cardiac catheterization using the wrist approach, the sheath is removed and an inflatable band, similar to a Please see WRIST on A9

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Wrist hours and often longer until the puncture site is From A8 closed, whereas they can sit up immediately after a bracelet, is placed over the puncture site to close radial procedure. Dr. Lewis notes that it. With the groin approach, manual compres- RIVAL and other large studies suggest that the sion over the puncture greatest benefits of a site is necessary. In addition, patients need to radial approach may be lie in bed for at least two seen in people treated for

Radial Artery Access Advantages • Lower risk of bleeding at the access site • Less bruising and discomfort • Faster recovery; patients can sit up immediately after the procedure and move around quicker • No need to stop anticoagulant therapy (blood thinners), which may contribute to a lower risk of serious complications such as stroke

Limitations • Not everyone is a candidate; a person without good blood flow through the other major artery to the hand or who has had bypass surgery involving the radial artery would not be a candidate • Requires specialized training and experience on the part of the interventional cardiologist • Venue challenges; the radial artery is prone to quirky anatomy and can be difficult to navigate, and its smaller size may not allow use of tools needed for some procedures

When to be concerned... • If you have new or worsening symptoms that raise concern about the risk of a heart attack, or if a test such as a stress test suggests increased risk, here are questions to ask: • Is cardiac catheterization the best next step in evaluating my risk for a heart at tack? What are the potential benefits and risks of the procedure? • Am I a candidate for a radial approach to catheterization? If not, why? • Is the doctor who will be performing the catheterization equally experienced and comfortable with a radial approach as he or she is with a femoral approach? • If the test shows I have blocked arteries, what is the next step? • If there is more than one option for treatment, what factors determine which option is best for me?

Although in existence for 20 years, the wrist technique was not embraced in the United States until recently. That trend is changing as research increasingly shows that the wrist approach is associated with fewer complications and a better patient experience.

an acute heart attack. These studies show that when a cardiologist is experienced and comfortable treating an acute heart attack using the radial approach, not only is bleeding risk lower but there are fewer strokes, heart attacks and deaths in the 30 days following the procedure.

A strong endorsement from patients

In November 2010, 22% of the catheter-based procedures performed were done radially. In January 2012, 67% of the procePatient feedback on dures performed used a radial artery access carradial approach. diac catheterization has “This ship has been overwhelmingly fasailed,” says Dr Jan. vorable. “Patients come in asking specifically for “We are ‘married’ to the the wrist approach,” says radial artery now.” He believes that as new Dr. Lewis. “They may have heard about it from catheters and smaller sheaths are developed a friend or neighbor or had a previous procedure for thinner arteries, the percentage of procefrom the groin.” dures done radially will Kim White, Assistant Director of Invasive Cardiology at The Chester County Hospital, agrees that people who have experienced a femoral procedure previously have the most positive things to say about radial access. “They are the ones we hear from the most,” she says. “They know that a femoral procedure can be more uncomfortable, particularly the need to lay flat for hours.” She notes that people with back pain or other problems that make lying for a prolonged period difficult are much happier to have a radial procedure.

increase even further. Dr. Lewis is equally confident that the number and complexity of radial procedures that take place at The Chester County Hospital will continue to grow. “The Hospital is being very proactive. Our percentages are ever increasing, and our results have been excellent.” During the 15 months we have performed radial procedures, there have been no reportable complica-

teca

tions. Only two femoral site complications were reported in 2010. Dr. Lewis says they are now treating patients in the throes of acute heart attacks radially and are comfortable with the procedure. “We have performed a few,” he says, “and they went beautifully.” This article was originally published in Chester County Hospital’s Synapse Magazine.

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Accelerated Low Risk Cardiac Symptom Protocol Reduces treatment time and improves patient satisfaction This protocol originated through a collaboration of Emergency physicians, Cardiologists and Directors at Chester County hat do you Hospital to decrease the do when length of time patients you think with symptoms of early you are heart attacks spend in having a the ED and, if needed, get heart attack? Hopefully, them the appropriate treatyour answer would be ment as soon as possible. call 9-1-1! But we underPrior to the development stand the hesitation. It of this protocol, many could just be inpatients experiencing digestion, it could cardiac symptoms were “Accelerated Low be stress, it could admitted to the hospital be any number of Risk Cardiac Sympand observed over a things — and, you tom Protocol” alllonger period of time don’t want to clog to ensure there was no lows patients exup the Emergency heart damage related to Department (ED), periencing chest the episode of pain. or spend hours pain symptoms or With this new waiting when you protocol, patients who aren’t sure, right? other early signs remain stable with norWell, unless of a heart attack to mal EKGs and troponin you get checked be observed and levels are discharged by out by a health the emergency physiprofessional, you treated in the Main cian with follow-up will never know. Emergency Depart- provided by the hosAnd, you could pital’s Cardiovascular ment. potentially avoid Nurse Navigator (See a life-threatening article about Cardiac situation down the Nurse Navigator on road. What’s more? The this page). The Nurse preted by an Emergency wait is over. physician for abnormality Navigator reaches out to For those who think discharged patients to disand blood tests are run at they are experiencing a cuss cardiac risk factors three-hour intervals to test heart attack, we have deand helps to expedite an for Troponin. Troponin is veloped a special protocol appointment with a cara protein released when called the “Accelerated diologist within 72 hours. there is damage to the heart Low Risk Cardiac Sympmuscle. An increase would The Nurse Navigator is tom Protocol.” indicate the beginnings of a also available to patients as Patients experiencing an ongoing resource for heart attack. chest pain symptoms or education, information If at any time during other early signs of a heart treatment a patient experi- and support. attack are observed and Since this protocol ences abnormal vital signs, treated in the Main Emerhas been implemented, abnormal EKGs or an gency Department. Upon arrival, a clinician increase in troponin levels, Chester County Hospital patients are overall satisthe Emergency Room runs through a series of physician would admit the fied to get the care they questions and tests with patient to the hospital and need in a timely manner the patient to calculate a while avoiding a hospia Cardiologist would be Thrombolysis in Myocartal stay. consulted. dial Infarction Score or By Donna Taylor, RN Cardiovascular Nurse Navigator

W

TIMI Score. The lower the score, the lower the risk for heart attack. It the patient’s score is greater than 2, they will be immediately admitted to the hospital and a cardiology consultation will be ordered. If the patient’s score is less than 2, a series of tests and observation will begin. Three periodic EKGs are performed and inter-

Sunday, February 9, 2014

Charting a course for cardiac patient rehabilitation

By Jeff Hoagland jhoagland@dailylocal.com When a person suffers a heart attack, has heart surgery, or undergoes a procedure like stenting or angioplasty, cardiac rehabilitation plays an important role in reducing their odds of having a future cardiac event. Donna Taylor, RN, Cardiovascular Nurse Navigator at Chester County Hospital, has the job of connecting cardiac patients to the rehabilitation and wellness services offered at the hospital. Her goal is to provide the patient the tools and resources necessary to prevent another cardiac event. Taylor enters the picture once a patient has been treated and discharged. Within 72 hours after a patient leaves the hospital, Taylor will call them. It’s a routine follow up call. She asks if they are having any issues, or have questions about medications. She then starts the patient on their follow-up care plan by scheduling their time in cardiac rehab. For some patients this can be a scary time, wrought with unknowns. For that reason Taylor is always accessible. When a patient needs to speak to her, there is no secretary answering the call, no recorded voice asking if they know their party’s extension. When a patient calls, Taylor’s cell phone rings. “It’s very satisfying to patients to be able to reach me so easily. Every patient has my number,” she said. Heart disease doesn’t go away. It’s a disease that lasts a lifetime,

Taylor said. “Once you have heart disease, it is more important than ever to take care of yourself. We try to provide our patients guidance and support to stay healthy and prevent future cardiac events,”

Donna Taylor, RN, Cardiovascular Nurse Navigator at Chester County Hospital, has the job of connecting cardiac patients to the rehabilitation and wellness services offered at the hospital. Her goal is to provide the patient the tools and resources necessary to prevent another cardiac event. she said. “Once you have heart disease, it is more important than ever to take care of yourself. We try to provide our patients guidance and support to stay healthy and prevent future cardiac events,” she said. This objective is easily measured by looking at readmission rates. “We have decreased readmission rates for cardiac patients because of follow-up care,” Taylor said. That follow-up care is a multifaceted approach of education, Please see NURSE on A11

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What do you get when you put

PediAtRiCs, iNteRNAl MediCiNe,

OB-GYN,

RehABilitAtiON,

CANCeRCARe,

iMAGiNG, lAB,

Nurse

& PRiMARY CARe

The catheterization lab team at Chester County Hospital.

said. “Some people are obese. Some are diabetic. From A10 Everyone is different. counseling and physical That is why our cardiac activity. Counseling and rehab is individualized to education helps a patient the patient.” understand their condition Taylor has held the and how they can best position of Cardiac Nurse manage it. Typical rehab Navigator for the past involves 18 to 24 sessions four years. However, her at the hospital’s Fern Hill experience with cardiac campus. That would be patients is extensive. Prior about three times a week to her current position she for physical therapy with was the charge nurse in education interspersed. the cardiac catheterization “Studies show that people lab, essentially running who do cardiac rehab live the lab on a daily basis for longer,” Taylor said. seven years. And while While Taylor said some Taylor’s work is now patients can be apprehen- conducted mostly on the sive to start the physical phone with patients, she activity portion of rehab still gets into the cath after a cardiac event, the lab regularly. Working environment they are clinically in the cath lab doing it in is very conallows her to keep her trolled and they are under skills sharp and maintain constant supervision. “In certain certifications. It cardiac rehab patients are also keeps her close to the monitored, so it’s safe. doctors and nurses who There are also cardiolotreat the very patients she gists on site,” Taylor said. is guiding through follow“Heart disease isn’t a up care. disease of the elderly. We While her own clinical have people in their 30s, experience has given her people who are runners. a wealth of knowledge Cardiac rehab has all she can share with her patypes of patients,” Taylor tients, the close relation-

ship Taylor has with the nurses and doctors means she can get immediate answers for them. “If I don’t know the answer, I can ask a doctor and take care of it quickly,” she said. “It’s an easier transition to have been a cardiac nurse and step into this nurse navigator role,” Taylor said. “I can easily contact the cardiac physicians. I know them, they know me.” “The catheterization lab team is great,” Taylor said. The team has been together for a long time and they are very good at being proactive and making positive changes. Our cardiologists are nimble. They regularly incorporate new treatments.” Most people are very receptive to the follow-up care prescribed by the hospital. “Having a cardiac event makes people reevaluate their lives,” Taylor said. “People are willing to change after having a heart attack. If patients do what they are supposed to, I won’t hear from them again.”

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