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Standards Regarding Echocardiographic Facilities, Equipment and Standard Operating Procedures

Standards Regarding the Examining Room
Standard F1: Echocardiographic examining rooms shall meet specific standards.

 

Standards Regarding Echocardiographic Imaging Systems
Standard F2: Ultrasound instruments utilized for diagnostic studies shall include required hardware and software to perform specific items.


Standard F3: Equipment shall be maintained in good operating condition.


Standards regarding Operating Procedures
Standard F4: All orders or requisitions for echocardiographic procedures shall include required information.

 

Standard F5: Sufficient time shall be allotted for each examination.

 

Standard F6: Echocardiographic reports shall be provided within the specific timeframes.

 

Standard F7: Echocardiographic data (images, measurements, and final reports) obtained for diagnostic purposes shall be recorded, stored and archived in a format that ensures ready retrieval (such that the parameters outlined in
Standard F6 are met), complete review, clear communication and patient confidentiality.

 

Standard F8: A permanent record of the images and interpretation shall be made and retained in accordance with provincial guidelines for medical records.

 

Standard F9: Laboratories shall have protocols whereby unexpected high risk findings are communicated immediately by the interpreting physician to the referring physician and managed as required by the interpreting/responsible echocardiologist.

 

Standard F10: Echocardiography Laboratories shall have Infection Prevention and Control (IPAC) Policies and Protocols in place.


Additional Standards for Laboratories Providing Stress Echocardiography Examinations
Standard FS1: Appropriately trained and qualified personnel are required to monitor the patient, operate the treadmill or supine bicycle, record the electrocardiogram and, in the case of pharmacologic stress echo, administer
medication. The individual(s) carrying out the examination shall not be expected to provide these functions.

 

Standard FS2: All stress procedures shall be explained to the patient and/or the substitute decision maker of those unable to give informed consent. Consent shall be obtained in a manner consistent with the rules and regulations outlined by the hospital or facility.
 

Standard FS3: Larger rooms shall be provided to perform stress echo, in order to accommodate extra equipment, personnel and potential resuscitation procedures. It is recommended that the procedure room be a minimum of 150
to 200 square feet.
 

Standard FS4: Facilities and procedures shall be available for observation and recovery of patients by appropriately trained and qualified personnel prior to the patient’s discharge home or back to their referring location.
 

Standard FS5: In addition to the echocardiographic imaging system requirements, echocardiography equipment utilized for stress echo studies shall meet specific requirements.
 

Standard FS6: In addition to the standard features noted above, laboratories providing stress echocardiographic examinations require specific additional items in the procedure room.


Additional Standards for Laboratories Providing Transesophageal Echocardiographic Examinations
Standard FT1: Appropriately trained and qualified personnel are required to provide sedation and monitoring of the patient through the procedure and recovery. The individual(s) carrying out the examination shall not be expected to provide this monitoring function during the procedure.
 

Standard FT2: All TEE procedures shall be explained to the patient and/or the substitute decision maker, and understanding confirmed prior to obtaining informed consent. Consent shall be obtained in a manner consistent with the rules and regulations outlined by the hospital or facility. Where sonographers are involved in the consent process, procedures shall be in keeping with the provisions of their credentialing body as well as relevant scope of practice principles established by the hospital or facility.
 

Standard FT3: In addition to the echocardiographic imaging system requirements, transesophageal transducers shall be available and meet the specific requirements.
 

Standard FT4: Larger rooms shall be provided to perform Transesophageal echo, in order to accommodate extra equipment, personnel and potential resuscitation procedures. It is recommended that these procedure rooms have a minimum of 150 to 200 square feet available.

 

Standard FT5: In addition to the standard features required to perform Transesophageal examinations, laboratories providing Transesophageal echocardiographic examinations shall have specific additional requirements in the procedure room.


Standard FT6: The echocardiography laboratory shall follow proper cleaning, disinfection, and maintenance procedures as stipulated by manufacturer and hospital or facility policies which meet Public Health Ontario Standards.


Standard FT7: Physical space and procedures shall be available to support the observation and recovery of patients by appropriately trained and qualified personnel, prior to the patient’s discharge home or back to their referring
location.