Improving cardiovascular nurse-led health services: Advocating for the clinical advanced practice and nurse practitioner role'

Published version reproduced here with permission from publisher. Copyright (2016) Australian Nursing and Midwifery Federation

A new frontier for nursing: the service-practice gap

Article used here with permission from the publisher.Pressures to avoid hospital admissions, improve service delivery, facilitate cost effectiveness and enhance access to healthcare services have led to the development of expert nursing roles

The household economic burden for acute coronary syndrome survivors in Australia

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS) experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship. Methods: Australian patients admitted to hospital with ACS during 2-week period in May 2012, enrolled in SNAPSHOT ACS audit and who were alive at 18 months after index admission were followed-up via telephone/paper survey. Regression models were used to explore factors related to out-of-pocket expenses and economic hardship. Results: Of 1833 eligible patients at baseline, 180 died within 18 months, and 702 patients completed the survey. Mean out-of-pocket expenditure (n = 614) in Australian dollars was A$258.06 (median: A$126.50) per month. The average spending for medical services was A$120.18 (SD: A$310.35) and medications was A$66.25 (SD: A$80.78). In total, 350 (51 %) of patients reported experiencing economic hardship, 78 (12 %) were unable to pay for medical services and 81 (12 %) could not pay for medication. Younger age (18–59 vs ≥80 years (OR): 1.89), no private health insurance (OR: 2.04), pensioner concession card (OR: 1.80), residing in more disadvantaged area (group 1 vs 5 (OR): 1.77), history of CVD (OR: 1.47) and higher out-of-pocket expenses (group 4 vs 1 (OR): 4.57) were more likely to experience hardship. Conclusion: Subgroups of ACS patients are experiencing considerable economic burden in Australia. These findings provide important considerations for future policy development in terms of the cost of recommended management for patients

Development, piloting and validation of the Recommending Cardiac Rehabilitation (ReCaRe) instrument

Background: Health practitioners’values, attitudes and beliefs largely determine their referrals to cardiac rehabilitation (CR).Objective:To develop and test the Recommending Cardiac Rehabilitation scale (ReCaRe), designed to assess health professionals attitudes, values and beliefs to CR referral. Methods: ReCaRe was appraised for: content validity (Delphi method, expert panel); interpretability and face validity (interview, health professionals); factor structure and internal consistency (survey, health professionals); and test-retest reliability (survey, health professionals). Normative scores were collated. Results: ReCaRe initially comprised 75 items. Initially, a Content Validity Index (CVI) was calculated for ratings of item relevance (CVI range; 0.271.0), which resulted in the removal of 19 items. After preliminary validation and psychometric testing, 34 items were factor-analysed (n= 24) providing a 17-item, four-factor scale: perceived severity and susceptibility (a= 0.93,k= 0.37); perceived service accessibility (a= 0.91,k= 0.67); perceived benefit(a= 0.97,k= 0.47); perceived barriers and attitudes (a= 0.82,k= 0.49). ReCaRe normative scores (n= 75) are reported.Conclusions:This psychometric analysis found ReCaRe to demonstrate good face validity, internal consistency and fair to substantial test-retest reliability. The next step is to validate these initial findings on a larger sample size to confirm whether ReCaRe can enable identification of factors impacting CR referra

Measuring performance and outcomes of acute coronary syndromes management in Australia

A national registry for acute coronary syndromes will improve patient care and clinical results.3 page(s

Coming of age: affiliate member profile and participation in the Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand

Background: Nursing, allied health and technical personnel are increasingly being recognised as pivotal in the diagnosis and management of heart disease. This recognition is mirrored in research, scholarship and professional development activities. Documenting the evolution and progression of a group's professional development is a useful strategy in informing future strategic initiatives. Aim: The purpose of this paper is to illustrate the development and participation of the Affiliates group within the Cardiac Society of Australia and New Zealand (CSANZ). Method: Data related to CSANZ membership, participation in the Annual Scientific Meeting as well as the number, type and ranking of abstracts were retrieved from CSANZ records for the period 1995-2003. These data were analysed using descriptive statistics. Results: Since the introduction of the Affiliate member status in 1988, membership has grown steadily, as has participation of members in the governance of the CSANZ. Mean abstract grades of Affiliate members are increasingly comparable with those of the FCSANZ, Ordinary and Associate members. Conclusions: Affiliate members are increasing their profile in the highly competitive environment of the Annual Scientific Meeting, demonstrating the critical role of nursing, allied health and technical professions in cardiovascular health and science. © 2007 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand

Facilitating or getting in the way? The effect of clinicians' knowledge, values and beliefs on referral and participation.

Background: Despite the compelling evidence of the benefits of cardiac rehabilitation (CR) on risk factor modification, quality of life and mortality reduction, a significant proportion of eligible patients are not referred or do not participate. Factors influencing CR referral and participation are complex and are likely patient, referral system and clinician-related. Little is known about clinician-related factors, which include attitudes, values and beliefs towards CR, or how these factors affect patient referral and attendance. This review examines the current evidence in the literature in relation to clinicians' attitudes, values and beliefs about CR. Methods: A review of the literature was conducted on studies in relation to clinicians' attitudes, values and beliefs toward CR. An expert consensus methodology was used to develop the concepts presented in this paper. Results: Besides guidelines, a range of other factors influence clinicians' view about CR. This review suggests that clinicians lacking cardiac qualifications may have limited knowledge and awareness of CR and its benefits. Low agreement among clinicians on who is more likely to benefit from CR was also identified. Clinicians' personal lifestyle and health belief, the availability and quality of local the CR programme, and the lack of a standard administrative process of referral can also hinder the referral of patients to CR. Conclusions: Clinician-related factors are important to consider in relation to CR referral and participation. Education for clinicians, discussion of local services and the support of an efficacious system at programme and organisation levels are essential