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.)
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Department of Cardiology, Medical Centre Alkmaar, Alkmaar, the Netherlands
Department of Cardiology, Exeter Hospital, Exeter NH, USA
Department of Cardiology, Medical Centre Alkmaar, Alkmaar, the Netherlands
Department of Cardiology, University Medical Centre, Groningen, the Netherlands
Department of Cardiology, University Medical Centre, Groningen, the Netherlands
Department of Cardiology, Medical Centre Alkmaar, Alkmaar, the Netherlands
V.A. Umans Medical Centre Alkmaar, PO Box 1800, 1815 JD Alkmaar, the Netherlands
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Broers, C.J.M., Sinclair, N., van der Ploeg, T.J. et al. The post-infarction nurse practitioner project. NHJL 17, 61–67 (2009). https://doi.org/10.1007/BF03086219
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DOI: https://doi.org/10.1007/BF03086219