PAGE 80 JOURNAL OF VASCULAR NURSING SEPTEMBER 2009

www.jvascnurs.net

the outcomes of patients with peripheral arterial disease. The goals

of the Critical Limb Care Program are to identify untreated asymp-

tomatic and symptomatic individuals, provide a comprehensive,

multidisciplinary approach to the management of peripheral arterial

disease, decrease fragmentation of resources, and provide longitudi-

nal care of patients. Coordinating resources and services to maxi-

mize convenience for patients is a key feature of the program and

ensures patient follow-up. Program elements consist of noninvasive

and invasive vascular testing, leading-edge revascularization thera-

pies, access to clinical trials, and a state-of-the-art wound clinic

designed only for lower extremity wound care. Healthcare services

in the Critical Limb Care program are provided by a multidisciplin-

ary team who are committed to practicing an outcome-driven

approach that uses evidence to drive decision making. The collabo-

rative relationship among team members promotes evidence based

practices and tracking of outcomes. The Outcomes Manager,

a Master’s prepared registered nurse, facilitates the outcomes driven

approach with the team. Data is collected in a systematic fashion,

reported to the team on a regular basis, and used to improve the

quality of care delivered to patients. The program to date has dem-

onstrated successful outcomes including decreased time to treat-

ment, successful revascularization, healing rates above the

national average, and an increase in volume and consultations.

P6

Success With An Innovative Critical Limb ScreeningProgram

Holly Lawyer, RN, BSN, Elaine Losego, RN, BSN,

Roxanne Finley, RN, BSN

Riverside Methodist Hospital, Columbus, Ohio

Riverside Methodist Hospital, a 1,059 bed regional referral

center, has been serving the central Ohio community as a private,

not-for-profit hospital since 1892. Recognized locally, regionally

and nationally for its quality care, service and reputation, River-

side has been a top 50 ranking hospital in U.S. News & World

Report for seven consecutive years.

Our vision for peripheral services included a comprehensive

program that included an accessible and meaningful peripheral

screening program.

The goal of our screening program is:

To grow heart and vascular procedure volumes through a new

patient acquisition strategy that focuses on clinical collaboration

and sustained outreach efforts to reach the approximately 87%

of the population whose peripheral artery disease is not recognized

and/or not treated.

Strategic goals were developed for the program. Many hospi-

tal departments, physician groups (locally and regionally) have

been included in a collaborative approach.

The poster will share:

- Detail regarding program elements such as targeted screen-

ing packages that were developed and marketed for CT

(calcium scoring), carotid artery ultrasound, ABI, and Ab-

dominal aortic ultrasound

- Screening objectives and screening processes

- Associated Marketing materials: patient and physician-tar-

geted brochures, information sheets, and multi-media

advertising examples (TV, print)

- Outcomes that will be shared include costs, volume and

revenue impacts, and actual screening results, such as the

percentage of patients showing PAD and their post-screen-

ing disposition (physician follow-up, Invasive and non-in-

vasive testing, interventional procedures, and quality of life

improvements)

P7

A Description of Outcomes Associated With IsometricExercise and Low Level Treadmill Walking DuringDobutamine Cardiolite Stress Tests

Linda Adams, MSN,RN,CCRN, Becky Kessler, BSN, RN,

Susan Butas, BSN, RN

Riverside Methodist Hospital, Columbus, Ohio

The purpose of cardiac stress testing is to evaluate the patient’s

ability to adequately perfuse the myocardial tissue. There are three

methods used to perform a Nuclear Cardiac Stress Test: Adeno-

sine, Stress Cardiolite, and Dobutamine. Some form of exercise

is helpful to achieve target heart rate in patients undergoing

Dobutamine Cardiolite Stress Tests. The outcomes of low level

exercise (slow treadmill walking) and isometric exercise to

achieve target heart rate during Dobutamine Cardiolite Stress

Tests have not been examined.

The purpose of this study was to describe the outcomes for

subjects who performed isometric exercise and subjects who per-

formed low level treadmill exercise while receiving Dobutamine

during their Cardiolite stress test. The outcomes of interest are

the amount of Dobutamine and Atropine used; Dobutamine

related side effects, duration of Dobutamine infusion, and quality

of cardiac images. This study was conducted in the cardiac stress

lab of a Midwest metropolitan teaching hospital. A convenience

sample of 60 patients (30 in each group) who required a Dobut-

amine Cardiolite Stress Test was recruited from April to Septem-

ber, 2008. Data analysis was conducted utilizing descriptive

statistics for each group. The data revealed the subjects who

walked on the treadmill required a lower dose of Dobutamine as

well as a decreased time of Dobutamine to achieve their target

heart rate. The data also revealed the image quality was better

with the subjects who walked on the treadmill.

P8

Ankle-Brachial Index Measurement: Vascular CuffVersus Standard Cuff/Sphygmomanometer

Elmira Asongwed, MS, RN, CNE, Steven Chesbro, PT, DPT,

EdD, GCS

University of the District of Columbia, Washington DC

The ankle-brachial index (ABI) is an effective and non-

invasive technique for peripheral arterial disease (PAD) detection.

Research on the efficacy of various cuff types to obtain ABIs

could not be found. The purpose of this study was to determine

the inter-rater and intra-rater reliability of ABI measures using

vascular and standard cuffs.

Two raters trained in ABI measurement using the Society for

Vascular Nursing protocol participated in this study. Each rater

completed two vascular and two standard cuff trials per individual