Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Feb;17(2):61-7.
doi: 10.1007/BF03086219.

The post-infarction nurse practitioner project: A prospective study comparing nurse intervention with conventional care in a non-high-risk myocardial infarction population

C J M Broers  1 , N Sinclair, T J van der Ploeg, T Jaarsma, D J van Veldhuisen, V A W M Umans
Affiliations

The post-infarction nurse practitioner project: A prospective study comparing nurse intervention with conventional care in a non-high-risk myocardial infarction population

C J M Broers et al. Neth Heart J. 2009 Feb.

Abstract

Objectives: To confirm the feasibility of nurse practitioner interventionin non-high-risk patients with recent myocardial infarction (MI).

Design: Observational study.

Setting: Acute coronary care unit in a teaching hospital.

Methods: We performed an open-label feasibility study to identify non-high-risk MI patients and evaluate the outcome of a new nurse practitioner intervention programme. The initial pilot phase served to identify the non-high-risk population. In the subsequent confirmation phase, 500 consecutive non-high-risk post-MI patients with preserved LV function without heart failure were included to receive nurse practitioner management. The nurse practitioner intervention started on transfer from the coronary care unit to the cardiology ward and continued thereafter for up to 30 days.

Main outcome measures: Time to first event analysis of death from all causes or repeat myocardial infarction.

Results: 500 Patients without signs of heart failure or depressed LV function were identified as nonhigh- risk and eligible for inclusion in the nurse practitioner intervention programme. In the implementation phase, none of the patients died and 0.9% developed a repeat myocardial infarction after 30 days of follow-up. Compared with the pilot phase, patients in the implementation phase spent fewer days in hospital (mean 11.1 versus 6.2 days; p<0.001).

Conclusion: It is feasible to identify non-high-risk post-MI patients, who can be managed adequately by a nurse practitioner. Embedding experienced nurse practitioners within critical care pathways may result in significant decreases in length of hospital stay. (Neth Heart J 2009;17:61-7.Neth Heart J 2009;17:61-7.).

Keywords: myocardial infarction; nurse practitioner; post-infarction management.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient flowchart.
Figure 2
Figure 2
Mean length of stay for nurse practitioner care (per quartile).
See this image and copyright information in PMC

References

    1. American Heart Association 2004. Heart disease and stroke statistics – 2004 update. Dallas Texas. Available at www.americanheart.org
    1. Fye WB, Hirshfeld JW. 35th Bethesda conference report: cardiology workforce crisis: a pragmatic approach. JACC 2004;44:215-75
    1. Escaned J, Rydén L, Zamorano JL, Poole-Wilson P, Fuster V, Gitt A, et al. Trends and contexts in European cardiology practice for the next 15 years: the Madrid Declaration: a report from the European Conference on the Future of Cardiology, Madrid, 2-3 June 2006. Eur Heart J 2007;28:634-7. - PubMed
    1. Lambrew CJ, Dove JT, Friday BA, Lloyd Doherty C, Nocero MA Jr, et al. Working group 5: innovative care team models and processes that might enhance efficiency and productivity. JACC 2004;44:251-6. - PubMed
    1. Mehta RH, Montoye CK, Faul J, Nagle DJ, Kure J, Raj E, et al., for the American College of Cardiology Guidelines Applied in Practice Steering Committee. Enhancing quality of care for acute myocardial infarction : shifting the focus of improvement from key indicators to process of care and tool use. JACC 2004;43:2166-73 - PubMed

LinkOut - more resources