The. set new goals and direction to support cardiovascular professionals, in all fields of practice.

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1 Pulse Spring 2007 The CCI Welcomes New President by John H. Toptine, RCS, RDCS, FASE A publication of Cardiovascular Credentialing International It is a pleasure and honor to serve as President of Cardiovascular Credentialing International. Having participated on the board for nearly ten years, it has been exciting to witness all of the changes. I have seen the organization move from an old testing format of paper and pencil to a modern computer-base testing format, go through a management change, expand services and support our Registrants more dynamically over the years. I am privileged to now work with an incredible group of leaders to help continue the path and Inside A controversy in Diagnostic Ultrasound...2 See you in Seattle!...3 CCI s Code of Ethics...5 Changes at CCI...5 Keeping Your Credential s Status Active...6 Credential Renewal March 31, CCI Credential(s) Renewal Process...8 Credentialing, Professional Standards and You...10 set new goals and direction to support cardiovascular professionals, in all fields of practice. The CCI Board of Trustee s just returned from a very productive 2007 Board meeting, where we heard great reports from our Exam Committee Chairs showing continued growth in all of our exams. We also heard reports from our Sponsoring Bodies, including the American College of Cardiology (ACC), American College of Chest Physicians (ACCP), the American Society of Echocardiography (ASE), the British Society of Echocardiography (BSE), the Society of Invasive Cardiovascular Professionals (SICP), the Society for Vascular Ultrasound (SVU), and the Thai Cardiovascular Invasive Society (TCIS), which consisted of updates on their outlook of the cardiovascular community and input on the future of CCI. The Board of Trustee s also spent a good portion of this meeting going through a strategic planning session, setting goals for the coming years. The CCI Board of trustees has set forth a plan for the next several years that I am excited to be a part of. We are confident by year s end we will have fulfilled all the requirements of the American National Standards Institute (ANSI) / International Standards Organization (ISO) accreditation process. Personally, I want to thank John Toptine, President, presents Elaine Shea, Immediate Past President, with plaque recognizing contribution to CCI and Cardiovascular Field. the national office staff and specifically Aaron White, CCI s Executive Director, for all the hard work they have put into this application process. CCI as an organization will be much stronger and better respected with the ANSI/ISO stamp of approval. Other exciting news is that CCI will be offering a new registry examination by the end of This new registry examination will test the fundamental knowledge of specialists working in the One of our first accomplishments in this coming year will be CCI s submission of our ANSI accreditation application. continued on page 10

2 Cardiovascular Credentialing International Board of Trustees & Executive Staff President John H. Toptine, RCS, RDCS, FASE President-Elect Christopher M. Nelson RN, RCIS, FSICP Treasurer Douglas L. Passey, RCIS, NREMT-P Secretary James J. Shafer, RVS, RVT Immediate Past President & Invasive Exam Committee Chair Elaine A. Shea, RCIS, RCS, FASE Non-Invasive Echo Exam Committee Chair Dennis K. Carney, RCIS, RCS, FASE Vascular Exam Committee Chair & Society for Vascular Ultrasound (SVU) Representative Claudia A. Benge, RVS, RVT, RDMS, RDCS CCT and CV Science Exam Chair Christie Hill Jordan, RCIS, RCS, RDCS, FASE American College of Cardiology (ACC) Representative Joseph V. Messer, MD, MACC American College of Chest Physicians (ACCP) Representative J. Nilas Young, MD American Society of Echocardiography (ASE) Representatives Kenneth D. Horton, RCS, RDCS, FASE Nelson B. Schiller, MD British Society of Echocardiography (BSE) Representative Simon Ray, MD Society of Invasive Cardiovascular Professionals (SICP) Representative Tracy L. Simpson, RCIS Member at Large Theodore C. Christman, RCIS, RCS, RVS Public Member Philip M. (Mel) Snyder, IV Executive Director & Editor of The Pulse Aaron S. White The Pulse and CCI are trade names of CCI. The Pulse is copyrighted by CCI and authorization to photocopy items for internal or personal use is granted by CCI. Opinions expressed in The Pulse are not necessarily those of the CCI Board of Directors, its agents, editors, advertisers or anyone connected with the publication. CCI assumes no liability or responsibility for any claims, actions or damages resulting from publication of any article. CCI does not endorse nor recommend any review course or review material. Cardiovascular Credentialing International 1500 Sunday Drive, Suite 102, Raleigh, NC 27607; phone: ; fax: (919) ; Cardiovascular Credentialing International. All rights reserved. My viewpoint regarding a controversy in Diagnostic Ultrasound by Claudia A. Benge, RVS, RVT, RDMS, RDCS Recently I have been following a list serve question in ultrasound regarding the utilization of preliminary technical reports. 1. Should a sonographer allow their observations during an ultrasound exam be given to the ordering physician? 2. Should the ordering physician use these observations to treat a patient? 3. Should the administration of the diagnostic ultrasound laboratory allow these technical observations to be disseminated to the ordering physician? 4. Should the Medical Director of the ultrasound laboratory be contacted before releasing these technical observations in either a routine or an emergent situation? Professional liability is definitely something that fuels this debate. Also, what if the technical prelim is wrong? The patient is at risk in a situation such as this. In my experience at various institutions both hospital and private, we released technical observations to the referring physicians without an interpreting physician review: a. Only if the results were normal b. We used the guidelines for normal ultrasound study based on nationally recognized criteria (that our physicians used for their interpreting guidelines). c. We stressed to the referring physician, that these were ONLY technical preliminary notes and had NOT been read by the interpreting physician. d. Our technical notes were written on a standard document that had a notation that these notes were not an official interpretation and should not be used as such. e. And written documentation of the call to the ordering physician was made on either the technical preliminary notes or in the patient s chart. If the ultrasound examination had ANY possibility of an abnormality, we would call the interpreting physician and have them come and read the examination ASAP. Then the interpreting physician would read the examination and make some notations and sign them. Frequently the interpreter would dictate the final report. And if the interpreting physician did not call the report, we were authorized to call the referring doctor and report only what the interpreting physician had dictated. We had written standards for technical preliminary notes and/or observations. The Medical Director and the Administration had reviewed and signed off on these protocols. The bottom line is even if you are a one person ultrasound lab, you need written protocols for these situations. And your interpreting physician, administration and legal department should agree to your technical preliminary reporting protocol. 2

3 See you in Seattle! The American Society of Echocardiography s 18th annual Scientific Sessions, scheduled for June 16-20, is rapidly approaching. The ASE Scientific Sessions were initiated in 1990 to showcase and communicate the latest research and developments in cardiovascular ultrasound. That first meeting was held in the Washington DC area and had 700 attendees. Contrast that to the over 3,000 registrants last year! Over the years, the meeting has expanded by adding core curricula, other didactic educational sessions, an intraoperative echocardiography session utilizing live cases, symposia with international echocardiography societies and other US cardiovascular organizations, and a meeting highlights session. The goals of the meeting remain to advance research in echocardiography and to communicate the latest developments in cardiovascular ultrasound so that our membership can practice appropriate echocardiography to the highest quality standards. This year s Scientific Sessions Program Committee, under the leadership of Roberto M. Lang, MD, FASE, has created an exciting program. The Washington State Convention Center offers a great environment for this meeting. We will be offering a comprehensive program tailored to the educational needs of physicians, sonographers, nurses and researchers. There are sessions geared for all levels of expertise, and attendees have the opportunity to earn CEUs that are accepted by CCI towards registry requirements for sonographers. The meeting will start Saturday and Sunday with multiple thematic symposia including topics such as pediatric/adult congenital heart disease, intraoperative echocardiography, quantification of LV function, 3D echocardiography, and the always popular, You are the Surgeon. This year we have taken a fresh approach to the content and organization of the Sessions. All new this year will be hands-on sessions where practitioners will be able to actively participate and perform echocardiographic imaging of complex congenital heart lesions, imaging and quantitation of ventricular dysynchrony and practice three dimensional echocardiographic imaging and display, all under the supervision of experts. Sonographers will also have the opportunity to participate in an IV Insertion session and get hands-on experience in this area. Other highlights will include: an expanded moderated poster session, the popular case competition, the Feigenbaum Lecture and the Young Investigator competition at new places and times, the comprehensive curriculum tracks for vascular ultrasound, pediatric echocardiography and sonography, the chance to operate on the heart at the You are the Surgeon session, the intraoperative symposium with live cases from Northwestern University, and the end of the meeting highlight session summarizing the key new developments of the year will also feature the 10 th Anniversary of Echo Jeopardy- be sure to join host John Gorcsan, III, MD for this fun and educational event! Finally, there will be plenty of social events for you to mingle and network with colleagues- Sunday night will feature the Members-Only Event, while Monday evening will offer the President s Reception for all attendees, and the Taste of Seattle Reception, sponsored by Echo ToolBox TM. There will be many opportunities to network with colleagues, pick the brains of international experts in cardiology, explore the latest products from leaders in the ultrasound industry, and celebrate the American Society of Echocardiography. As you can see, we have planned an exciting meeting for you in a city that is vibrant, fun, historic, and friendly. We have been promised weather conducive to both enjoying the meeting but also exploring the city and we will have great views of Mount Ranier. The renovated Convention Center is conveniently located close to the hotels. So make plans now to join us in the wonderful city of Seattle in June! Visit for more information and to register! Michael Picard, MD President, ASE 3

4 CCI does not endorse nor recommend any review course or review material.

5 Changes at CCI Beginning with Registrants whose credential(s) are due for renewal on March 31, 2007, a new step will be added to the CCI Credential Renewal Process. In addition to submitting the required amount of CEUs obtained through approved CCI Continuing Education Providers and the submission of the require renewal fees, all Registrants must also submit a signed copy and comply with CCI s Code of Ethics. CCI s Code of Ethics The purpose of the CCI Code of Ethics is to acknowledge the Registrant s acceptance of the responsibility and trust conferred upon it by the organization and to acknowledge that earning a CCI credential is a privilege that must be earned and maintained. The delivery of safe, competent and ethical patient care is a responsibility of the highest order. This document sets forth the Code of Ethics to be adhered to by credentialed cardiovascular technologists awarded the CCI credentials: Certified Cardiographic Technician (CCT), Registered Cardiovascular Invasive Specialist (RCIS), Registered Cardiac Sonographer (RCS) and Registered Vascular Specialist (RVS). All credentialed cardiovascular technologists awarded a CCI designation shall, in their professional activities, sustain and advance the integrity and honor of the profession by adhering to this Code of Ethics. Certificants who intentionally or knowingly violate any provision of the Code of Ethics will be subject to action by a peer review panel, which may result in revocation of the certification. 1. As a credentialed cardiovascular technologist / technician, I will place the safety, health and protection of the patient above all other interests. 2. As a credentialed cardiovascular technologist / technician, I will demonstrate and maintain professional competence in all aspects of patient care and within the scope of practice as defined by my employer. 3. As a credentialed cardiovascular technologist / technician, I will represent my credential(s) accurately, honestly, and will not attempt to maintain CCI credentials by fraud, deception or artifice. 4. As a credentialed cardiovascular technologist / technician, I will not knowingly assist another person or persons in obtaining or attempting to obtain or maintain CCI credentials by fraud, deception or artifice. 5. As a credentialed cardiovascular technologist / technician, I will uphold professional standards by adhering to defined technical protocols and diagnostic criteria established by peer review. 6. As a credentialed cardiovascular technologist / technician, I will represent my qualifications honestly and provide only those services for which I am qualified to perform. 7. As a credentialed cardiovascular technologist / technician, I will defend and protect the patient s right to privacy and confidentiality, unless required to disclose such information by law. 8. As a credentialed cardiovascular technologist / technician, I will consistently maintain and improve professional competence through regular assessment of skills, continuing education, experience and professional training. 9. As a credentialed cardiovascular technologist / technician, I will accept responsibility for maintaining the credential by meeting renewal requirements and remaining in good standing with CCI. 10. As a credentialed cardiovascular technologist / technician, I will voluntarily report any criminal behavior resulting in a conviction of a misdemeanor or felony. continued on page 8 5

6 Keeping Your Credential s Status Active Registrants whose credentials active status expired December 31, 2006 had a 90- day grace period to complete the renewal process which ended on March 31, All registrants who have not submitted renewal fees and required CEU s by this date will be required to retake an exam to become active. If submitting ceus by mail, please send copies, not original certificates, to our National Offices at 1500 Sunday Drive, Suite 102, Raleigh, NC If submitting by fax, please fax copies to our CEU FAX LINE at Please allow 2-3 business days for these ceus to be reviewed and posted to the CEU Tracker. In peak renewal times, please allow up to 7 business days for posting to appear on the CEU Tracker. We have provided some samples of ceu certificates, both acceptable and unacceptable. To avoid renewal delays, please be sure the certificates you submit follow this format. In-Service lists are unacceptable unless they include all required information and are generated by your employer. Registrants whose credentials active status expired March 31, 2007 have a 90- day grace period to complete the renewal process which will end on June 30, All registrants must now submit a signed copy of CCI s Code of Ethics, a copy of which was sent to you with your renewal invoice. If you have not sent in your renewal fees and signed Code of Ethics yet, you still have time. If you need a copy of CCI s Code of Ethics, you can download one from our website, org. Registrants renewing for the first time are not required to submit ceus. We applaud those who earn ceus during that initial period, however CCI does not require submission of ceus during the initial registration period. While we do not recommend or endorse specific courses or websites, as a convenience for our registrants, we have compiled a list of approved providers of ceu credits and popular websites which can be accessed on our website by clicking on Registrant Services, CEU Submission. The sites listed are just a small sampling of Internet sources of accredited ceus. CCI realizes that attending seminars to earn ceus can be costly and time consuming. We urge our registrants to avail themselves of the numerous Internet sites where ceu credits can be earned and certificates printed, many of which are available at little or no cost. We remind you to verify that the ceu website is accredited by an approving body on our list before completing any activities. This information is usually on the Home Page of the individual website. Sample of Acceptable CEU Certificate Sample of Unacceptable CEU Certificate 6

7 Keeping Your Credential s Status Active continued from page 6 Sample of Acceptable Inservice List ABC REGIONAL MEDICAL CENTER Course Approving CEUs Date Body Awarded Completed ANGIO SEAL INSERVICE SDMS 4.0 Feb. 11, 2005 GUIDANT BALLOON DESIGN SICP 2.0 Jan. 6, 2003 MEDTRONIC BALLOON PROFILE SICP 1.0 July 2, 2003 GUIDEWIRE SELECTION SICP 2.0 August 4, 2004 CARDIAC DRUGS INDICATION FOR USE SDMS 4.0 Feb. 11, 2005 BI-VENTRICULAR PACING SVU 5.0 July 2, 2003 ELECTROSURGERY BASICS SVU 2.0 March 15, 2005 ACLS RECERTIFICATION AMA 4.0 April 23, 2005 BLS RECERTIFICATION AMA 1.0 May 5, 2005 PROCEDURAL SEDATION ASE 4.0 August 25, 2004 ACT ASE 2.0 March 7, 2003 END OF LIFE CARE ACCP 4.0 August 15, 2005 ROTATIONAL ATHERECTOMY SDMS 4.0 October 27, 2004 CARDIOLOGY UPDATE SICP 2.0 October 10, 2003 The above sample Inservice List is acceptable since it shows CEUs/contact hours awarded and approved provider names and is generated by employer. Sample of Unacceptable Inservice List COURSE DATE COMPLETED ANGIO SEAL INSERVICE Feb. 11, 2005 GUIDANT BALLOON DESIGN Jan. 6, 2003 MEDTRONIC BALLOON PROFILE July 2, 2003 GUIDEWIRE SELECTION August 4, 2004 CARDIAC DRUGS INDICATION FOR USE Feb. 11, 2005 BI-VENTRICULAR PACING July 2, 2003 ELECTROSURGERY BASICS March 15, 2005 ACLS RECERTIFICATION April 23, 2005 BLS RECERTIFICATION May 5, 2005 PROCEDURAL SEDATION August 25, 2004 ACT March 7, 2003 END OF LIFE CARE August 15, 2005 ROTATIONAL ATHERECTOMY October 27, 2004 CARDIOLOGY UPDATE October 10, 2003 Credential Renewal March 31, 2007 CCI s Registrant Services Department has been receiving and processing renewal payments and ceus for registrants whose credential s status expired March 31, We are pleased to see that so many of our registrants have already fulfilled their three-year renewal requirement. If you have not completed your renewal requirements, you have a grace period until June 30, 2007 to submit ceus, signed Code of Ethics and renewal payment. Please be aware that there is a late fee of $45.00 which has been assessed to all registrants who have not yet met their renewal requirements. If renewal requirements are not completed by June 30, 2007, credential s status will become Inactive and registrants will be required to retest to become active again. We urge our registrants who have not submitted the required ceus, Code of Ethics form and renewal payment to do so prior to June 30, 2007 to avoid retesting. The above sample Inservice List is unacceptable since it does not show CEUs/contact hours awarded nor approved provider names and was not generated by employer. 7

8 CCI Credential(s) Renewal Process 1. Submission of required CEUs. (RCIS, RCS, or RVS = 36 CEUs, 30 of which must be cardiovascular in subject content. CCT = 16 CEUs) Note: Newly credentialed Registrants are not required to submit CEUs until the end of their first triennial cycle, but must complete sections 2 and 3 of the Renewal Process at the time of their credential s first renewal. 2. Submission of required renewal fees. 3. Submission of a signed copy of CCI s Code of Ethics. We have included a copy of CCI s Code of Ethics in this issue of The Pulse for your information. A copy of CCI s Code of Ethics can also be found on our website CCI does not endorse nor recommend any review course or review material. 8

9 CCI s Code of Ethics continued from page As a credentialed cardiovascular technologist / technician, I will avoid deceptive acts which misrepresent my academic or professional qualifications. 12. As a credentialed cardiovascular technologist / technician, I will avoid compromise of professional judgment by conflicts of interest. 13. As a credentialed cardiovascular technologist / technician, I will engage only in legal arrangements and practices in the health-care field. 14. As a credentialed cardiovascular technologist / technician, I will act in a manner free of bias with regard to religion, ethnicity, gender, age, national origin, disability, social or economic status. 15. As a credentialed cardiovascular technologist / technician, I understand that the certificate, logo and marks are the property of CCI and I will not misrepresent or inappropriately use the property of CCI. I agree to return the wallet card and certificate of my credentialing, upon request, to the CCI Board of Trustees. 16. As a credentialed cardiovascular technologist / technician, I will uphold and follow all policies and procedures required by the CCI to remain in good standing, and I will abide by CCI s Code of Ethics. SICP Chapter Conference Call Schedule The Chapter Networking Group meets regularly via conference call. If you are considering organizing a chapter and have questions or if you already have organized a chapter and can give advice, etc., please join us. Calls are every other month, the third Wednesday of the month at 7:00 pm Central time. Please send your contact info to Nicole Shore at director@sicp.com. We will include you in our mailing list. Our schedule is: May 16 July 18 September 19 November 14 (earlier because of Thanksgiveing holiday) SICP at SCAI s Annual Scientific Sessions! Join us for SICP s Signature RCIS Review Course on May 12th as part of SCAI s Annual Scientific Sessions. For registration information for SCAI s Scientific Sessions, as well as for the SICP RCIS Review Course, please visit or The Society for Cardiovascular Angiography and Interventions 30th Annual Scientific Sessions, Judkins Cardiac Imaging Symposium and Complex Coronary Complications (C3) Summit The Best of the Best in Interventional Cardiology May 9-12, 2007 Disney s Contemporary Resort Orlando, FL View program information and register at Feel free to contact me any time with questions. Lynne Jones,RN, RCIS, FSICP President CCI does not endorse nor recommend any review course or review material. 9

10 New President Electrophysiology laboratories all across the country. CCI has tagged this new credential a Registered Cardiac Electrophysiology Specialist (RCES). We look forward to seeing our first Registered Cardiac Electrophysiology Specialist (RCES) by year s end. Currently a task force of electrophysiology professionals is working on completing the steps involved in getting this new and exciting examination ready for the first applicants to sit for this registry. The International Board of Heart Rhythm Examiners (IBHRE), formerly NASPEeXAM, through its leadership have been working with CCI on this new credentialing examination, while the Heart Rhythm Society (HRS), formerly NASPE, has also been in con- stant communication with CCI s EP Task Force. CCI appreciates the input from these two fine organizations. The Board of Trustees also spent some time discussing the Care Bill and how this could affect our Registrants and how we can better align ourselves to make sure that our Registrants are protected if this Bill should pass into law. More to come on this topic in the next issue of The Pulse. These are just three examples of the thrilling changes that will be coming in 2007 and the plans for 2008 and beyond, I think, will be just as exhilarating. continued from page 1 I just want to reiterate that it is my pleasure and honor to serve as President for Cardiovascular Credentialing International. I hope I will be able to lead this organization as proudly as my predecessors before me have done. If you have any concerns please feel free to contact me through the CCI website at Look in the About CCI tab, under the Board of Directors link. I look forward to hearing your input on where you feel CCI needs to concentrate its efforts to better serve you. CCI wants to hear from you! Send us an article about your department and we will publish it in The Pulse. Please send to: jpunzi@cci-online.org Include photo if available. CCI does not endorse nor recommend any review course or review material. 10

11 CCI does not endorse nor recommend any review course or review material. 11

12 PRSRT-STD US POSTAGE P A I D RALEIGH, NC PERMIT # Sunday Drive, Suite 102 Raleigh, NC