A New Radiology Care Unit

When plans for the Dennis and Carol Troesh Medical Campus began to take shape, a need for recovery services for radiology became apparent. The main portion of Gastrointestinal Services (GI) was to remain in the Cloverleaf Towers and would still need to have a recovery space. Interventional Radiology (IR) was also remaining in its space in Schuman Pavilion. Cardiac services was being moved to the first floor of the Dennis and Carol Troesh Medical Campus and was creating its own pre- and post-intervention location. With the move of Perioperative services to the new campus, the distance was quite far for the procedural preparation and recovery for GI and IR services. In addition, there were increases in surgical capacity, so it was determined that GI and IR procedure prep and recovery should be done in another location. The newly developed Radiology Anesthesia Care Unit (RACU) would take over the soon to be vacated perioperative location in the Cloverleaf towers. The Radiology Procedural Care Unit (RPCU), located in new facility, was identified as a site that would create a compliant space for inpatient recovery post procedures and for recovery of patients whose tests may be in new facility such as CT, MRI, Nuclear Medicine and Pulmonary.

In order to make these new locations a reality, this new department was created and placed under the direction of Sarah Capalla, MSN, RN, CCRN-K, CNRN, VA-BC, and Ebony Hillery, BSN, RN, Matthew Sinner, BSN, RN, the educator for all the areas reporting to Sarah Capalla, would also take on the education needs of the new Radiology Care Unit (RACU/RPCU combined) department. Radiology Care Unit (RCU) was given positions for 20 RNs, including one charge RN and four PCAs. Since the department was starting from new, all workflows, policies, standing orders, and guidelines had to be created. Working with a team of nurses who would be coming to the new location when opened allowed for these processes to be built from the perspective of the bedside.

The staff helped to create processes by reaching out to all the areas that would be serviced by RACU/RPCU and asking what functions were working with the current processes and which were not. They then began to create processes to meet all needs. Working closely with the new Cardiac Post Anesthesia Care Unit, documentation was created to allow for standardization between all pre and post locations. The staff also created training on procedures to help with the orientation of staff who would be caring for the patients pre- and post-procedure so they would be aware of what was involved, and potential complications.

The RCU opening has been a vital area for addressing specialized patient needs and reducing overcrowding in the perioperative areas as the nurses can focus on preparing what is needed for each procedure. This focus has fostered an improvement in patient care handoff pre- and post-procedure. During recovery, having the nurses increase their familiarity with each procedure allows them to tailor their recovery and post-procedure education for the patient. Since the RCU functions as a preparation area for procedures, there has been an increase in the patients being ready when the procedure room is available for them, thus preventing delays. During post recovery phone calls, patients have spoken positively about the amazing care they have received in the RCU, and we are gearing up to have our own consumer report to reflect the care provided.