What impact do specialist and advanced-level nurses have on people living with heart failure compared to physician-led care? A literature review

2020 ◽  
pp. 174498712094679
Author(s):  
Dean A Anderson ◽  
Victoria Clemett

Background The inclusion of specialist nurses in multi-disciplinary teams is the current gold standard for care of people with heart failure (HF) in the UK; however, they remain underutilised in practice. Though existing systematic reviews favourably compare advanced nursing roles to physician-led care, none has focused solely on HF. Aim To investigate the impact of specialist and advanced nurse-led care on the clinical outcomes, quality of life and satisfaction of people with HF compared to physician-led care. Methods Literature review and narrative synthesis. Results This review included 12 studies and categorised their measured outcomes into five domains: mortality; hospital admissions and length of stay; HF diagnosis and management; quality of life and patient satisfaction; and finally, self-assessment and self-care. Five studies appraised as medium or low risk of bias suggest the impact of specialist and advanced-level nurses on people with HF to be broadly equivalent to physicians regarding mortality, hospital admissions and length of stay, while superior in terms of self-assessment and self-care behaviours. Conclusions There were too few studies of sufficient methodological quality to draw definitive conclusions. However, no evidence was found to suggest that nurse-led services are any less effective or safe than physician-led services.

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Paloma Garcimartín ◽  
Monica Astals-Vizcaino ◽  
Neus Badosa ◽  
Anna Linas ◽  
Consol Ivern ◽  
...  

Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognizing symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate self-care management and quality of life changes on patients with heart failure and assessed by a pilot study, for three months, to sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p<.001) and emergency admission (IRR 4.24; p<.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assign-ment_group=-.881; p<.001) and in the quality of life (βSlope. Assignment_group=1.739; p<.001). This study supports that a nurse-led program on symptom recognition and fluid restriction can have a positive impact on self-care behaviours and quality of life in patients with heart failure.


2021 ◽  
Vol 8 (06) ◽  
pp. 5469-5489
Author(s):  
Stergiani Petaloti ◽  
Zoe Roupa ◽  
Ekaterini Lambrinou ◽  
Maria Noula

Background: Νon-pharmacological management programs for patients with chronic disease severe Heart Failure (HF) syndrome which programs are managed by nurses with interventions that promote self-care, self-management, self-maintenance, empowerment, behavior modification, have shown encouraging results the reduction of re-admissions, hospitalization days and positive results such as the reduction of hospital costs of the provided health care the costs of the Health Care System. The purpose of this Systematic Review (SR) is to examine all recent prospective studies that evaluate the impact of Non-Pharmacological Management Programs by Healthcare Professionals - Nurses in the Health Related Quality of Life (HRQofL) of HF Patients. Material and Method: After searching for published studies in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Library a total of 30 studies were found to meet the inclusion criteria in this review of which 6 systematic reviews, 15 randomized controlled trials, 4 randomized pilot studies, 2 experimental studies and 3 prospective studies. Results: Nursing education and non-pharmacological management programs for patients with HF seem to be successful and effective in improving the self-care and autonomy of patients with HF but no correlation was observed with the improvement of HRQofL. Conclusions: Further prospective studies are needed to evaluate the results of Non-Pharmacological Nursing Management of patients with HF in relation to follow-up time in the sample homogeneity, intensity and type of program to identify the most effective interventions to improve quality of life.


Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognizing symptoms do not readily triggers an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate self-care management and quality of life changes on patients with heart failure and assessed by a pilot study, for three months, to sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p<.001) and emergency admission (IRR 4.24; p<.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group=-.881; p<.001) and in the quality of life (βSlope. Assignment_group=1.739; p<.001). This study supports that a nurse-led program on symptom recognition and fluid restriction can have a positive impact on self-care behaviours and quality of life in patients with heart failure.


2010 ◽  
Author(s):  
J. A. Cully ◽  
L. L. Phillips ◽  
M. E. Kunik ◽  
M. A. Stanley ◽  
A. Deswal

2021 ◽  
Vol 11 (2) ◽  
pp. 418-429
Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).


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