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A nurse‐led implantable loop recorder service is safe and cost effective
Author(s) -
Lim Wei Yao,
Papageorgiou Nikolaos,
Sukumar Shivasankar M.,
Alexiou Sophia,
Srinivasan Neil T.,
Monkhouse Christopher,
Daw Holly,
Caldeira Helder,
Harvie Helen,
Kuriakose Jincymol,
Baca Marco,
Ahsan Syed Y.,
Chow Anthony W.,
Hunter Ross J.,
Finlay Malcolm,
Lambiase Pier D.,
Schilling Richard J.,
Earley Mark J.,
Providencia Rui
Publication year - 2019
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14206
Subject(s) - medicine , implantable loop recorder , catheter , emergency medicine , surgery , medical emergency , atrial fibrillation
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.