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Perpetua EM, Palmer R, Le VT, Al-Khatib SM, Beavers CJ, Beckman JA, Bozkurt B, Coylewright M, Lloyd Doherty C, Guibone KA, Hawkey M, Keegan PA, Kirkpatrick JN, Laperle J, Lauck SB, Levine G, Lindman BR, Mack MJ, Price AL, Strong S, Wyman JF, Youmans QR, Gulati M. JACC: Advances Expert Panel Perspective: Shared Decision-Making in Multidisciplinary Team-Based Cardiovascular Care. JACC. ADVANCES 2024; 3:100981. [PMID: 39130036 PMCID: PMC11312306 DOI: 10.1016/j.jacadv.2024.100981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/25/2024] [Accepted: 02/28/2024] [Indexed: 08/13/2024]
Abstract
Shared decision-making (SDM) and multidisciplinary team-based care delivery are recommended across several cardiology clinical practice guidelines. However, evidence for benefit and guidance on implementation are limited. Informed consent, the use of patient decision aids, or the documentation of these elements for governmental or societal agencies may be conflated as SDM. SDM is a bidirectional exchange between experts: patients are the experts on their goals, values, and preferences, and clinicians provide their expertise on clinical factors. In this Expert Panel perspective, we review the current state of SDM in team-based cardiovascular care and propose best practice recommendations for multidisciplinary team implementation of SDM.
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Affiliation(s)
- Elizabeth M. Perpetua
- Empath Health Services, Seattle, Washington, USA
- School of Nursing, Department of Biobehavioral Nursing and Informatics, University of Washington, Seattle, Washington, USA
| | - Roseanne Palmer
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Viet T. Le
- Intermountain Health, Salt Lake City, Utah, USA
| | - Sana M. Al-Khatib
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Craig J. Beavers
- University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Joshua A. Beckman
- Southwestern Medical Center, University of Texas, Dallas, Texas, USA
| | | | | | | | | | - Marian Hawkey
- Hackensack University Medical Center, Heart and Vascular Hospital, Hackensack, New Jersey, USA
| | - Patricia A. Keegan
- Columbia University Irving Medical Center, Center of Interventional Therapy, New York, New York, USA
| | - James N. Kirkpatrick
- Emory Healthcare, Heart and Vascular, Atlanta, Georgia, USA
- Departments of Medicine and Bioethics and Humanities, Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Jessica Laperle
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Sandra B. Lauck
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Brian R. Lindman
- Vanderbilt University Medical Center, Division of Cardiovascular Medicine, Nashville, Tennessee, USA
| | | | | | | | - Janet F. Wyman
- Department of Structural Heart, Division of Cardiovascular Medicine, Henry Ford health System, Detroit, Michigan, USA
| | - Quentin R. Youmans
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Martha Gulati
- Preventive Cardiology, Barbra Streisand Women's Heart Center, Preventive and Cardiac Rehabilitation Center, Women's Cardiovascular Medicine & Research, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
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2
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Beavers CJ, Bessada Y, Bond R, Veneman K, Barnes GD. Leveraging the Cardiovascular Team in Peripheral Artery Disease Diagnosis: A Call to Action. J Multidiscip Healthc 2024; 17:2903-2910. [PMID: 38911613 PMCID: PMC11190329 DOI: 10.2147/jmdh.s466345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/06/2024] [Indexed: 06/25/2024] Open
Abstract
Lower extremity peripheral artery disease (PAD) is a common atherosclerotic cardiovascular disease (ASCVD) involving the aortoiliac, femoropopliteal, and infrapopliteal arterial segments. PAD remains a largely underdiagnosed and undertreated condition. The ankle-brachial index (ABI) is a simple and widely available test that is key detection tool in the diagnosis of PAD and is prognostic for mortality and morbidity. The cardiovascular (CV) team is a diverse array of health care clinicians (eg, nurses, nurse practitioners, physician assistants/associates, pharmacists, podiatrists) who have the qualifications and skills to be able to recognize when patients are at risk for PAD and perform an ABI. It is critical that the healthcare community recognize the critical role the CV team could play in improving outcomes and reducing disparities for patients with PAD.
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Affiliation(s)
- Craig J Beavers
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Youssef Bessada
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Rachel Bond
- DHMG Dignity Health Medical Group, Gilbert, AZ, USA
| | - Kristen Veneman
- Elliot Vascular Surgery, Elliot Hospital, Manchester, NH, USA
| | - Geoffery D Barnes
- Frankel Cardiovascular Center, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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3
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Baird AM, Hays K, Vlazny D. Shaping the future of vascular care: The evolution of advanced practice providers (APPs). Vasc Med 2024; 29:233-237. [PMID: 38506488 PMCID: PMC11010561 DOI: 10.1177/1358863x241237176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Alexandra Moran Baird
- Hospital Corporation of America, Cardiac and Vascular Service Line, Nashville, TN, USA
- Vanderbilt University School of Nursing, Nashville, TN, USA
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4
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Fraser M, Barnes SG, Barsness C, Beavers C, Bither CJ, Boettger S, Hallman C, Keleman A, Leckliter L, McIlvennan CK, Ozemek C, Patel A, Pierson NW, Shakowski C, Thomas SC, Whitmire T, Anderson KM. Nursing care of the patient hospitalized with heart failure: A scientific statement from the American Association of Heart Failure Nurses. Heart Lung 2024; 64:e1-e16. [PMID: 38355358 DOI: 10.1016/j.hrtlng.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Affiliation(s)
- Meg Fraser
- University of Minnesota MHealth Physicians, Minneapolis, MN, USA.
| | | | | | - Craig Beavers
- University of Kentucky College of Pharmacy, Lexington, KY, USA
| | | | | | | | - Anne Keleman
- MedStar Washington Section of Palliative Care, Washington, DC, USA
| | | | | | - Cemal Ozemek
- University of Illinois at Chicago, Cardiac Rehabilitation, College of Applied Health Sciences, Chicago, IL, USA
| | - Amit Patel
- Ascension St. Vincent Medical Group Cardiology, Indianapolis, IN, USA
| | - Natalie W Pierson
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
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5
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Smith MA, Zelenetz P, Kim A, Donaghy H, Gould JS, McLeod-Sordjan R. Curriculum and Competency Guidelines for the Advanced Care Practitioner in Infectious Disease. Open Forum Infect Dis 2024; 11:ofad589. [PMID: 38304731 PMCID: PMC10831324 DOI: 10.1093/ofid/ofad589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/05/2023] [Indexed: 02/03/2024] Open
Abstract
Background Changes in the health care delivery system have altered the way internal medicine (IM) is practiced, with inclusion of subspecialty advanced care practitioners (ACPs) as vital members of the health care team. Methods ACPs are provided the clinical settings and educational resources within an academic center to become competent in recognizing and managing common and complicated infectious diseases (ID). The ID ACP will be given progressive responsibility with expectations for achievement of milestones as they develop into competent practitioners. We seek to ensure quality, cost-effective, and comprehensive patient-centered care on the ID service in the inpatient and ambulatory settings in compliance with national standards and scope of practice recommendations and regulations. Results In recognition of the expanding role of ACPs, we developed a curriculum and guidelines in the subspecialty of ID. Conclusions Our proposal greatly adds to the available literature for ACPs to provide the full spectrum of ID practice.
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Affiliation(s)
- Miriam A Smith
- Daytonand Karen Brown Division of Infectious Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NewYork, USA
| | - Paul Zelenetz
- Daytonand Karen Brown Division of Infectious Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NewYork, USA
| | - Angela Kim
- Daytonand Karen Brown Division of Infectious Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NewYork, USA
| | - Henry Donaghy
- Daytonand Karen Brown Division of Infectious Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NewYork, USA
| | - J Scott Gould
- Hofstra/Northwell School of Nursing and Physician Assistant Studies, 160 Hofstra University, Hempstead, NewYork, USA
| | - Renee McLeod-Sordjan
- Hofstra/Northwell School of Nursing and Physician Assistant Studies, 160 Hofstra University, Hempstead, NewYork, USA
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6
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Crowley R, Pugach D, Williams M, Goldman J, Hilden D, Schultz AF, Beachy M. Principles for the Physician-Led Patient-Centered Medical Home and Other Approaches to Team-Based Care: A Position Paper From the American College of Physicians. Ann Intern Med 2024; 177:65-67. [PMID: 38145573 DOI: 10.7326/m23-2260] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Team-based care models such as the Patient-Centered Medical Home are associated with improved patient health outcomes, better team coordination and collaboration, and increased well-being among health care professionals. Despite these attributes, hindrances to wider adoption remain. In addition, some health care professionals have sought to practice independent of the physician-led health care team, potentially undermining patient access to physicians who have the skills and training to deliver whole-person, comprehensive, and longitudinal care. In this paper, the American College of Physicians reaffirms the importance of the physician-led health care team and offers policy recommendations on professionalism, payment models, training, licensure, and research to support the expansion of dynamic clinical care teams.
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Affiliation(s)
- Ryan Crowley
- American College of Physicians, Washington, DC (R.C., D.P., M.W.)
| | - David Pugach
- American College of Physicians, Washington, DC (R.C., D.P., M.W.)
| | - Margo Williams
- American College of Physicians, Washington, DC (R.C., D.P., M.W.)
| | - Jason Goldman
- Charles E. Schmidt College of Medicine, Boca Raton, Florida (J.G.)
| | - David Hilden
- Hennepin Healthcare, Minneapolis, Minnesota (D.H.)
| | | | - Micah Beachy
- University of Nebraska Medical Center, Omaha, Nebraska (M.B.)
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7
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Tennyson CD, Bowers MT, Dimsdale AW, Dickinson SM, Sanford RM, McKenzie-Solis JD, Schimmer HD, Alviar CL, Sinha SS, Katz JN. Role of Advanced Practice Providers in the Cardiac Intensive Care Unit Team. J Am Coll Cardiol 2023; 82:2338-2342. [PMID: 38057076 DOI: 10.1016/j.jacc.2023.08.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Carolina D Tennyson
- Duke University School of Nursing, Division of Cardiology, Duke Department of Medicine, Durham, North Carolina, USA.
| | - Margaret T Bowers
- Duke University School of Nursing, Division of Cardiology, Duke Department of Medicine, Durham, North Carolina, USA
| | - Allison W Dimsdale
- Duke University Health System, Advanced Practice Center, Division of Cardiology, Duke Department of Medicine, Durham, North Carolina, USA
| | | | | | | | - Hannah D Schimmer
- The Leon H. Charney Division of Cardiology, New York University Langone Medical Center & Bellevue Hospital Center, New York, New York, USA
| | - Carlos L Alviar
- The Leon H. Charney Division of Cardiology, New York University Langone Medical Center & Bellevue Hospital Center, New York, New York, USA
| | - Shashank S Sinha
- Inova Heart and Vascular Institute, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Jason N Katz
- Division of Cardiology, Duke Department of Medicine, Durham, North Carolina, USA
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Dhala A, Fusaro MV, Uddin F, Tuazon D, Klahn S, Schwartz R, Sasangohar F, Alegria J, Masud F. Integrating a Virtual ICU with Cardiac and Cardiovascular ICUs: Managing the Needs of a Complex and High-Acuity Specialty ICU Cohort. Methodist Debakey Cardiovasc J 2023; 19:4-16. [PMID: 37547898 PMCID: PMC10402825 DOI: 10.14797/mdcvj.1247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/12/2023] [Indexed: 08/08/2023] Open
Abstract
A long-standing shortage of critical care intensivists and nurses, exacerbated by the coronavirus disease (COVID-19) pandemic, has led to an accelerated adoption of tele-critical care in the United States (US). Due to their complex and high-acuity nature, cardiac, cardiovascular, and cardiothoracic intensive care units (ICUs) have generally been limited in their ability to leverage tele-critical care resources. In early 2020, Houston Methodist Hospital (HMH) launched its tele-critical care program called Virtual ICU, or vICU, to improve its ICU staffing efficiency while providing high-quality, continuous access to in-person and virtual intensivists and critical care nurses. This article provides a roadmap with prescriptive specifications for planning, launching, and integrating vICU services within cardiac and cardiovascular ICUs-one of the first such integrations among the leading academic US hospitals. The success of integrating vICU depends upon the (1) recruitment of intensivists and RNs with expertise in managing cardiac and cardiovascular patients on the vICU staff as well as concerted efforts to promote mutual trust and confidence between in-person and virtual providers, (2) consultations with the bedside clinicians to secure their buy-in on the merits of vICU resources, and (3) collaborative approaches to improve workflow protocols and communications. Integration of vICU has resulted in the reduction of monthly night-call requirements for the in-person intensivists and an increase in work satisfaction. Data also show that support of the vICU is associated with a significant reduction in the rate of Code Blue events (denoting a situation where a patient requires immediate resuscitation, typically due to a cardiac or respiratory arrest). As the providers become more comfortable with the advances in artificial intelligence and big data-driven technology, the Cardiac ICU Cohort continues to improve methods to predict and track patient trends in the ICUs.
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Affiliation(s)
- Atiya Dhala
- Houston Methodist Hospital, Houston, Texas, US
| | | | - Faisal Uddin
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US
| | - Divina Tuazon
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US
| | - Steven Klahn
- Department of Virtual Medicine, Houston Methodist Hospital, Houston, Texas, US
| | | | - Farzan Sasangohar
- Houston Methodist Academic Institute, Houston Methodist Hospital, Houston, Texas, US
- Texas A&M University, College Station, Texas, US
| | | | - Faisal Masud
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US
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9
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Physician Associates/Assistants in Primary Care: Policy and Value. J Ambul Care Manage 2022; 45:279-288. [PMID: 36006386 DOI: 10.1097/jac.0000000000000426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Since the new century, primary care physician supply has worsened. Analysts predict that health service demand in the United States will grow faster than physician supply. One strategy is the utilization of physician assistants/associates (PAs). Most PAs work full-time, and approximately one quarter are employed in family medicine/general medicine. PAs deliver primary care services in a team-oriented fashion in a wide variety of settings, including private health systems and community health centers. One fifth work in rural and medically underserved areas. Together PAs and nurse practitioners provide approximately one third of the medical services in family medicine, urgent care, and emergency medicine.
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10
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Frankel DS, Dechert-Crooks BE, Campbell K, DeSimone CV, Etheridge S, Harvey M, Lampert R, Nayak HM, Saliba WI, Shea J, Thomas J, Zado E, Daubert JP. 2021 HRS Educational Framework for Clinical Cardiac Electrophysiology. Heart Rhythm O2 2022; 3:120-132. [PMID: 35496459 PMCID: PMC9043382 DOI: 10.1016/j.hroo.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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11
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Chaney A, Beliles G, Keimig A, Porter I. Advanced Practice Provider Care Team Models: Best Practices From an Academic Medical Center. J Ambul Care Manage 2022; 45:126-134. [PMID: 35202029 DOI: 10.1097/jac.0000000000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Health care leaders must be innovative to meet the demands of patient access and cost efficiency, all while never compromising patient safety or experience. A clear understanding of the care team model with optimal utilization of all team members is paramount to success. This article discusses 5 nurse practitioner and physician assistant (collectively called advanced practice providers) care team models that regularly occur in health care organizations across the country. Examples of each practice model, a discussion on when each model would be appropriate, as well as data on patient experience and financial return of investment of each model are provided.
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Affiliation(s)
- Amanda Chaney
- Departments of Transplant (Dr Chaney) and Nephrology (Dr Porter), Mayo Clinic, Jacksonville, Florida; and Administration, Mayo Clinic, Jacksonville, Florida (Messrs Beliles and Keimig)
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12
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Cross-sectional study of healthcare accessibility in rural regions among patients with acute myocardial infarction. Int Emerg Nurs 2021; 60:101112. [PMID: 34929589 DOI: 10.1016/j.ienj.2021.101112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients suffering from acute myocardial infarction (AMI), mainly with ST elevation (STEMI), are at a great disadvantage in rural regions due to the lack of nearby hospitals with percutaneous coronary intervention (PCI). OBJECTIVE This study aimed to analyse AMI patients' interhospital referrals in a rural emergency department (ED), as well as the factors contributing to its system delay METHODS: A cross-sectional observational study was carried out. An analysis of hospital referral was conducted as well for time intervals: from the first medical contact (FMC), first electrocardiogram (ECG), contact with the PCI hospital, ED exit, and arrival at the catheterization laboratory ward. RESULTS Of the 48 eligible patients, 62.5% suffered from STEMI, and 50.0% were transferred to a PCI hospital. The median time to coronary intervention facilities was 214 min. The median time spent in the ED was 131 min, and time spent in transport was 101 min. The time interval to the first ECG was 6 to 10 min. CONCLUSIONS Interhospital referral of AMI patients in rural settings is inconsistent and often not in compliance with international guidelines. A long system delay time is related mainly to organizational issues. STEMI patients still experience significant delays in healthcare accessibility. Nurses' timely execution and interpretation of ECG can improve healthcare accessibility.
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Shen Z, Qin W, Zhu L, Lin Y, Ling H, Zhang Y. Construction of nursing-sensitive quality indicators for cardiac catheterisation: A Delphi study and an analytic hierarchy process. J Clin Nurs 2021; 31:2821-2838. [PMID: 34866256 DOI: 10.1111/jocn.16105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/22/2021] [Accepted: 10/05/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Nursing care can profoundly reduce the risk of emergencies related to cardiac catheterisation. Therefore, identifying nursing-sensitive quality indicators (NSQIs) to evaluate nursing quality is critical for optimal cardiac catheterisation. However, studies on NSQIs for cardiac catheterisation are scarce. OBJECTIVES This study was conducted to develop a set of NSQIs for cardiac catheterisation. METHODS Literature retrieval and expert group discussions were conducted to identify potential NSQIs and compile an inquiry questionnaire. Then, Delphi surveys were used to collect opinions from experts in the field of cardiac catheterisation. The consistency of the consultation results formed the basis on which we conducted the next rounds of consultation. Based on the importance given to each NSQI by the consulted experts in the previous round, we determined the weight coefficient of each indicator with the analytic hierarchy process. This study was performed according to the SRQR guidelines. RESULTS We conducted two rounds of expert inquiry. The recovery rates of the first and second questionnaires were 100% and 66.67%, respectively. The average authoritative coefficients were 0.86 and 0.91. The Kendall W values ranged from 0.214~0.361 (p < .001). Consensus was reached on 3 primary indicators, 8 secondary indicators and 20 tertiary indicators. CONCLUSIONS A set of NSQIs for cardiac catheterisation was developed. However, the effects of these NSQIs on the evaluation and continuous improvement of nursing quality in cardiac catheterisation need to be verified in clinical practice.
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Affiliation(s)
- Zhiyun Shen
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Qin
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Li Zhu
- Cardiac catheterization laboratory, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ying Lin
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huaxing Ling
- Cardiac catheterization laboratory, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuxia Zhang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
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14
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Implementing Nonphysician Provider Guideline-Directed Medical Therapy Heart Failure Clinics: A Multi-National Imperative. J Card Fail 2021; 27:896-906. [PMID: 34364666 DOI: 10.1016/j.cardfail.2021.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 01/01/2023]
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15
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Watson KE, Tsuyuki RT, Beahm NP, Sedore R, Bell A. Assessment of the educational competencies for the Hypertension Canada Professional Certification Program (HC-PCP) designed for implementation of hypertension guidelines into primary care. Can Pharm J (Ott) 2021; 154:271-277. [PMID: 34345320 PMCID: PMC8282914 DOI: 10.1177/17151635211016493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The uptake of clinical practice guidelines into practice is limited for many chronic conditions, including hypertension. The aim of this study was to ascertain the importance of the educational competencies for the development of the Hypertension Canada Professional Certification Program (HC-PCP) among frontline, primary care professionals (e.g., pharmacists, physicians, nurses). METHODS A group of hypertension experts developed 15 competencies believed to be important for primary care professionals to master when providing hypertension management. These competencies were surveyed for consensus by frontline clinicians through the Hypertension Canada e-newsletter in 2018. Clinicians were asked to rank the importance of each competency for a primary care provider to acquire when undertaking a certification in hypertension management, using a Likert scale from 1 (not important) to 5 (very important). RESULTS A total of 121 clinicians responded to the survey. Of these, 38% were pharmacists, 31.4% were registered nurses, 10.7% were physicians and 7% were nurse practitioners. There was at least 1 respondent from each Canadian province and territory, except for the Northwest Territories. All 15 competencies received a mean rank of at least 4. The competency with the highest ranking was Competency 6: Ability to screen and identify hypertension (mean 4.83 [0.04]). The competencies with the lowest average ranks were Competency 1: Demonstrates a sound knowledge of the epidemiology of hypertension (mean 4.07 [0.85]) and Competency 5: Demonstrates an understanding of the validation process for blood pressure devices (mean 4.15 [0.08]). CONCLUSIONS Clinicians generally ranked all 15 competencies to be of high importance for a provider who is certified in hypertension management to possess. These competencies and the current Hypertension Canada guidelines were used as the foundation for the development of an education program called the Hypertension Canada Professional Certification Program. Can Pharm J (Ott) 2021;154:xx-xx.
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Affiliation(s)
| | - Ross T. Tsuyuki
- EPICORE Centre, University of Alberta,
Edmonton, Alberta
- Hypertension Canada, Toronto
| | - Nathan P. Beahm
- Department of Medicine, and the Faculty of
Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton,
Alberta
| | | | - Alan Bell
- Department of Family and Community Medicine,
University of Toronto, Toronto, Ontario
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16
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Fernandes SM, Marelli A, Hile DM, Daniels CJ. Access and Delivery of Adult Congenital Heart Disease Care in the United States. Cardiol Clin 2020; 38:295-304. [DOI: 10.1016/j.ccl.2020.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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