A Royal Free London nurse is leading the way for nurses to carry out a procedure which is typically performed by doctors, saving time and improving patient experience.

Dorota Wojcik, senior cardiac catheter laboratory nurse at the Royal Free Hospital, has been working on nurse-led radial access for angiograms since 2018, and the procedure has since gone from strength-to-strength.

Radial access is the process of threading a thin catheter through the body’s arteries, using the wrist as an entry point and eventually reaching the heart. This offers lower risk of complications, improved patient comfort and lower cost compared to femoral access.

Traditionally completed by doctors, Dorota first became interested in carrying out the procedure herself when she noticed they had other duties to complete between procedures.

“Normally a nurse assists the doctor in the procedure, sort of like a second operator,” Dorota explained.

“Doctors then have to complete a report after every case, and go consent a new patient, which takes up their time. Very often patients would become impatient and begin asking when their turn is.

“I just thought it would be great if I could get access to the radial artery prior to the doctor coming in to the room, so that when they are ready the procedure can begin right away.”

 

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Dorota Wojcik, senior cath lab nurse at the Royal Free Hospital

Dorota began looking into the possibility of nurse-led radial access and created a policy for band 6 nurses to be trained to carry it out. This includes a nurse needing to complete 50 consultant supervised procedures and establish expertise in 100 further procedures.

By the end of phase two of the study into the feasibility of the project, independent successful radial access was achieved in 91% of procedures carried out by nurses and no immediate vascular complications were identified.

“Through many audits we proved that not only could we reduce waiting times, but we improved patients’ satisfaction scores and were able to carry out more procedures with the time saved,” Dorota said.

“We also don’t ‘take away’ training from doctors and they get priority, but I have find that I am able to help junior doctors with learning this procedure which is an added bonus.”

Dorota has shared the policy with other hospitals and offered workshops to NHS colleagues, with nurse-led radial access now being performed at Barts Health NHS Trust, Lister Hospital and Royal Brompton Hospital.

She has also presented her work nationally and internationally, including at the European Society of Cardiology in 2020 and at the Euro PCR, a world-leading course in interventional cardiovascular medicine, in 2021. Dorota also received the bronze award for cardiovascular nurse of the year at the British Journal of Nursing awards in March 2024.

“When I told my mentor Dr Gerry Coghlan that I won bronze, he said to get the gold we will have to get a nurse to do the full angiogram! So that is the next goal, which will take a lot of work to build up to again.”