Date of Graduation

Fall 12-13-2019

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

Program

Executive Leader DNP

First Advisor

Elena Capella, EdD MSN/MPA CNL CPHQ LNCC

Second Advisor

Juli Maxworthy, DNP, MSN/MBA, RN, CNL, CPHQ, CPPS, CHSE, FSSH

Abstract

Abstract

Problem. Patients with non-conditional cardiovascular implantable electronic devices (CIEDs), which lack magnetic resonance imaging (MRI) components, are unable to undergo MRI.

Context. The Heart Rhythm Society guidelines for patient device management and Centers for Medicare and Medicaid Services requirements for persons with specific expertise in implanted permanent devices to manage CIEDs during MRI spurred policy, procedure and staffing changes.

Interventions. The evidence-based change-of-practice project comprised of workflow development, policy and procedure changes, implementation of required staffing support to manage the CIED during an MRI.

Measures: The outcome measure was to improve access to MRI for patients with CIEDs, measured through data extracted from the Clinical Business Analytics reporting tool. Three process measures determined the change in numbers of patients presenting for, excluded from, or receiving MRIs as a consequence of the intervention.

Results. CIED MRI workflows and the revised policy and procedure were finalized. Since implementation of extended hours of CIED support on October 7, 2019, the arrhythmia NP has supervised 18 MRIs after 5 pm.

Conclusions. The project expanded MRI access and CIED management support for all patients, ensuring high-quality care aligned with institutional standards and government regulations.

Keywords: magnetic resonance imaging/MRI, cardiac implantable electronic devices/CIED, MRI safety, MRI adverse effects, CIED interference, pacemaker, implantable cardioverter defibrillator.

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