The Nurses' Role in the Cardiac Rehabilitation Team: Data From the Perfect-CR Study.
Matthias Lidin, Halldora Ögmundsdottir Michelsen, Emma Hag and 5 others
PMID 38912908WHAT IT FOUND
In Swedish cardiac rehabilitation, blood pressure and cholesterol target attainment was associated with nurses adjusting medicines using treatment algorithms and teams holding regular rounds with a medical director.
Key findings
01Centers where nurses independently adjusted blood pressure and lipid-lowering medication, had medication titration algorithms, counseling training, a medical director and regular team meetings were positively associated with systolic BP target attainment.
02Patients having the same nurse throughout follow-up, more hours with a nurse, and vocational support at initial assessment were positively associated with systolic BP target attainment.
03For LDL-C target attainment, nurse medication adjustment, tobacco treatment algorithms, nurse contribution to education, a medical director, regular case rounds, same nurse, and written risk factor targets were positively associated; receiving lab copies and initial lipid assessment were negatively associated.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational registry and survey study, so it cannot show that nurse practices caused patients to reach targets. Patients were only aged 18 to 74 and had to attend a 1-year cardiac rehabilitation follow-up visit, so it does not describe older patients or those who did not attend. All centers were in Sweden, so the findings may not apply to other countries. Center-level nurse practices were self-reported by cardiac rehabilitation centers in a survey, not directly observed. Some common nurse assessment activities were not analysed because nearly all centers reported doing them, so the study cannot compare centers that differed little on these tasks. Patients were receiving multiple cardiovascular treatments, including lipid-lowering therapy, ACE inhibitors/ARBs and beta-blockers, so the contribution of any single nurse-related component cannot be separated.
Declared interests
The authors declared no funding and no conflicts of interest.
The easy way to misread this
Do not read this as proof that nurse medication adjustment or team rounds caused patients to reach blood pressure and cholesterol targets. The study is observational, and the authors state that conclusions about causality cannot be made.