{"title":"An evaluation of a service expansion to include patients with heart failure with preserved ejection fraction","authors":"Jessica Peplow, Sharon Rees","doi":"10.12968/bjca.2023.0082","DOIUrl":"https://doi.org/10.12968/bjca.2023.0082","url":null,"abstract":"The Central London Community Healthcare Trust West Hertfordshire heart failure service expanded in 2020 to include patients with heart failure with preserved ejection fraction, in addition to the patients with heart failure with reduced ejection fraction. The patient population was predicted to double, requiring staff and service adjustments; this warranted an evaluation to determine if care targets were maintained. This study aimed to evaluate the impact of service expansion on service referral rates, length of stay in the service and clinical workload. A retrospective quantitative evaluation of the service data from October 2020 to April 2021 was undertaken to compare referral rates, length of stay in the service and key workload metrics between patients with heart failure with reduced ejection fraction and those with heart failure with preserved ejection fraction. All referrals to the service with a new diagnosis of heart failure (confirmed by echocardiogram or magnetic resonance imaging) were considered for evaluation. Of 250 eligible referrals, 81 were selected for inclusion using a random sampling method. Data were analysed using Chi square test, Fisher’s exact test or the Wilcoxon signed rank test; a P value of <0.05 indicated statistical significance. The participants with heart failure with preserved ejection fraction had a median length of stay in the service of 17 weeks. The participants with heart failure with reduced ejection fraction had a significantly longer stay of 35.57 weeks (P<0.001) compared to a pre-expansion length of stay of approximately 17 weeks. Workload was proportional between the two cohorts. Patients with heart failure with preserved ejection fraction were more likely to be reviewed in multidisciplinary teams or by the consultant community clinic. This group was less likely to attend clinic, with 96.4% of face-to-face reviews taking place at home. Telephone reviews occurred at a similar frequency for both cohorts, comprising 50% of follow ups. The heart failure with reduced ejection fraction cohort required more alterations in medication and medication titration, generating additional follow ups. The service expansion to include patients with heart failure with preserved ejection fraction has had a significant impact on workload, leading to a reduction in the quality of care for those with heart failure with reduced ejection fraction.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"13 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139776109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A season of change: managing menopause with adult congenital heart disease","authors":"B. Greenaway","doi":"10.12968/bjca.2023.0073","DOIUrl":"https://doi.org/10.12968/bjca.2023.0073","url":null,"abstract":"In this patient story, Beth Greenaway describes her experience of menopause and the additional challenges that a congenital heart condition can bring to this life stage.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"120 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139776530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A season of change: managing menopause with adult congenital heart disease","authors":"B. Greenaway","doi":"10.12968/bjca.2023.0073","DOIUrl":"https://doi.org/10.12968/bjca.2023.0073","url":null,"abstract":"In this patient story, Beth Greenaway describes her experience of menopause and the additional challenges that a congenital heart condition can bring to this life stage.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"90 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An evaluation of a service expansion to include patients with heart failure with preserved ejection fraction","authors":"Jessica Peplow, Sharon Rees","doi":"10.12968/bjca.2023.0082","DOIUrl":"https://doi.org/10.12968/bjca.2023.0082","url":null,"abstract":"The Central London Community Healthcare Trust West Hertfordshire heart failure service expanded in 2020 to include patients with heart failure with preserved ejection fraction, in addition to the patients with heart failure with reduced ejection fraction. The patient population was predicted to double, requiring staff and service adjustments; this warranted an evaluation to determine if care targets were maintained. This study aimed to evaluate the impact of service expansion on service referral rates, length of stay in the service and clinical workload. A retrospective quantitative evaluation of the service data from October 2020 to April 2021 was undertaken to compare referral rates, length of stay in the service and key workload metrics between patients with heart failure with reduced ejection fraction and those with heart failure with preserved ejection fraction. All referrals to the service with a new diagnosis of heart failure (confirmed by echocardiogram or magnetic resonance imaging) were considered for evaluation. Of 250 eligible referrals, 81 were selected for inclusion using a random sampling method. Data were analysed using Chi square test, Fisher’s exact test or the Wilcoxon signed rank test; a P value of <0.05 indicated statistical significance. The participants with heart failure with preserved ejection fraction had a median length of stay in the service of 17 weeks. The participants with heart failure with reduced ejection fraction had a significantly longer stay of 35.57 weeks (P<0.001) compared to a pre-expansion length of stay of approximately 17 weeks. Workload was proportional between the two cohorts. Patients with heart failure with preserved ejection fraction were more likely to be reviewed in multidisciplinary teams or by the consultant community clinic. This group was less likely to attend clinic, with 96.4% of face-to-face reviews taking place at home. Telephone reviews occurred at a similar frequency for both cohorts, comprising 50% of follow ups. The heart failure with reduced ejection fraction cohort required more alterations in medication and medication titration, generating additional follow ups. The service expansion to include patients with heart failure with preserved ejection fraction has had a significant impact on workload, leading to a reduction in the quality of care for those with heart failure with reduced ejection fraction.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139835970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing patient outcomes: 2023 focused clinical update on heart failure","authors":"Mairead Lehane, Antonia Docherty, Becky Hyland, Maggie Simpson, Leeanne Macklin","doi":"10.12968/bjca.2023.0103","DOIUrl":"https://doi.org/10.12968/bjca.2023.0103","url":null,"abstract":"This article provides an overview of the European Society of Cardiology 2023 focused clinical update on heart failure and considerations for practice. The latest focused clinical update provides an overview of up-to-date recommendations based on all major clinical trials and meta-analyses exploring heart failure that were published since 2021. The update outlined recommendations on treatment and management of chronic heart failure, acute heart failure, and comorbidities (including chronic kidney disease, type 2 diabetes, iron deficiency) and the prevention of heart failure.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"207 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Highlighting the latest research: February 2024","authors":"Sarah Jane Palmer, Helen Cowan","doi":"10.12968/bjca.2023.0104","DOIUrl":"https://doi.org/10.12968/bjca.2023.0104","url":null,"abstract":"Sarah Jane Palmer presents a selection of recently published articles of interest to nurses working in cardiovascular nursing, while Helen Cowan explores their application to practice. The aim of this roundup is to provide a brief overview of the research papers selected and highlight their relevance to cardiac nursing practice. A full reference is provided for those who wish to look at the research in further detail.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"35 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Hamer, Areej Mohamed, Zundus Ali-heybe, Emma Schnieder, J. Hill
{"title":"Calcium supplementation for the prevention of hypertension: a synthesis of existing evidence and implications for practise","authors":"O. Hamer, Areej Mohamed, Zundus Ali-heybe, Emma Schnieder, J. Hill","doi":"10.12968/bjca.2023.0010","DOIUrl":"https://doi.org/10.12968/bjca.2023.0010","url":null,"abstract":"In this commentary, Oliver Hamer and colleagues critically appraise the methods and findings presented in a Cochrane systematic review exploring the effectiveness of calcium dietary supplementation in preventing hypertension.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"220 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"COVID-19 outcomes in patients with pre-existing cardiovascular disease and risk factors: perspectives from a hospital in Ireland","authors":"Deirdre McGuone, Nicola Farrand, Geraldine Prizeman, Frances O'Brien","doi":"10.12968/bjca.2023.0097","DOIUrl":"https://doi.org/10.12968/bjca.2023.0097","url":null,"abstract":"COVID-19 has led to substantial changes in the provision of emergency healthcare services. International data suggest that COVID-19 is associated with increased morbidity and mortality in patients with pre-existing cardiovascular disease and cardiovascular risk factors. This study aimed to explore the association between pre-existing cardiovascular disease and/or cardiovascular risk factors and COVID-19 disease severity and outcomes in an Irish hospital. This retrospective study obtained data from a bioresource database of patients with confirmed COVID-19 infection (n=649) in a large hospital in Dublin. Data were collected on patients' demographic characteristics, cardiovascular diseases, cardiovascular disease risk factors and medications taken for cardiovascular conditions. The World Health Organization progression scale was used to assess the severity of COVID-19 infection in each patient. Cross-tabulation analysis was used to analyse associations between variables, with a P value of ≤0.05 indicating significance. Mortality rates were six times greater in patients with cardiovascular disease compared to those without cardiovascular disease (18.6% vs 3.1%). A higher percentage of patients with one or more cardiovascular risk factors had moderate (53.4%) or severe (19.1%) COVID-19 and higher mortality rates (10.7%) than those without cardiovascular risk factors. Of the patients who died from COVID-19 (n=40), 60.0% (n=24) had one or more cardiovascular diseases, while 80.0% (n=32) had one or more cardiovascular risk factors. Existing cardiovascular disease and cardiovascular risk factors increase the risk of more severe disease and worse clinical outcomes in patients with COVID-19. Many cardiovascular risk factors are modifiable, so it is important to consider preventative education strategies designed to reduce modifiable risk factors to improve outcomes for patients with COVID-19.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"17 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139597449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Gebremichael, A. Beleigoli, Jonathon W Foote, N. Bulamu, Joyce S. Ramos, Robyn A Clark
{"title":"Patient-reported experiences of cardiac rehabilitation services and the Country Heart Attack Prevention model of care","authors":"L. Gebremichael, A. Beleigoli, Jonathon W Foote, N. Bulamu, Joyce S. Ramos, Robyn A Clark","doi":"10.12968/bjca.2023.0061","DOIUrl":"https://doi.org/10.12968/bjca.2023.0061","url":null,"abstract":"Patient-centred care is the delivery of a high-quality healthcare service that appropriately responds to the needs and preferences of patients. Addressing participants' needs and preferences in healthcare services is essential to improving patients' experiences and clinical outcomes. This article aimed to evaluate patient-reported experiences of standard cardiac rehabilitation programmes and the Country Heart Attack Prevention model of care, as well as design and standardise patient-reported experience measures. This was a cross-sectional study with a multi-method analysis. Participants (n=818) ≥18 years old with cardiovascular disease who attended cardiac rehabilitation programmes across all modes of delivery before (1 January 2017 to 30 June 2021), during (1 July 2021 to 30 June 2022) and after implementation of the Country Heart Attack Prevention model (1 July 2022 to 30 December 2022) responded to the patient satisfaction surveys. Participant data from before and after implementation of the model were categorised as ‘not exposed’, while those who received cardiac rehabilitation during this period were categorised as ‘exposed’. A total of 170 participants provided qualitative feedback. Summary t-test was used to compare the means of the quantitative responses, and thematic analysis was used to generate themes from the qualitative feedback. The overall patient-reported satisfaction scores for those not exposed (n=685) and exposed (n=133) to the Country Heart Attack Prevention model of care were 77.1% and 85.9%, respectively (mean difference=−8.8; 95% confidence interval=−10.2, −7.4; P≤0.05). Themes for positive feedback included education and information, communication and friendly advice. Themes for improvement included follow-up duration, more face-to-face contact and waiting time. Overall patient-reported satisfaction scores were significantly higher for participants who were exposed to the Country Heart Attack Prevention model of care compared with those who were not exposed. Addressing feedback on areas for improvement in cardiac rehabilitation services can promote attendance, completion and improved health outcomes of patients.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"26 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139597877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"International nurse collaborations to improve cardiometabolic health: a professional visit report","authors":"Janice Richardson","doi":"10.12968/bjca.2023.0098","DOIUrl":"https://doi.org/10.12968/bjca.2023.0098","url":null,"abstract":"Janice Richardson describes her professional visit to the Dasman Diabetes Institute in Kuwait to provide support for a collaborative research project, known as KUDOS, exploring the relationship between excess liver fat and diabetes in different age groups.","PeriodicalId":502395,"journal":{"name":"British Journal of Cardiac Nursing","volume":"26 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139613592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}