The Journal of cardiovascular nursing
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Mortality from acute coronary syndromes has decreased. This achievement is based on the rapid recognition of possible acute coronary syndrome, obtaining an electrocardiogram for diagnosis, and the prompt initiation of therapy, including aspirin, oxygen, thrombolytics, and cardiac catheterization. The importance of rapid diagnosis and therapy is emphasized by American College of Cardiology/American Heart Association (ACC/AHA) practice guidelines. However, these goals are not always met, and their failure leads to increased mortality. The purpose of this study was to determine the frequency emergency department nurses report guideline-related activities when triaging patients for complaints suggestive of myocardial infarction. ⋯ We recommend tailored educational interventions be developed to improve nurses awareness of the importance of complying with the ACC/AHA standard of care practice goals and the necessity of achieving these goals all of the time as a path to improving patient outcome.
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Multicenter Study
Nurses' educational needs for pain management of post-cardiac surgery patients: a qualitative study.
Inadequate knowledge among health care providers is a key barrier to good pain management, and nurses have a major role to provide education to patients. The purpose of this study was to identify nurses' learning needs to prepare patients for managing pain before and after discharge home from cardiac surgery. The overall aim is to develop a pain education intervention for nurses working with cardiac surgical patients. ⋯ Participants identified the most common pain knowledge gaps for patients before and after discharge after cardiac surgery. These data will be used to develop an education intervention for nurses to help their cardiac surgery patients with more effective pain management strategies before and after discharge home.
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Adherence to evidence-based therapies has emerged as one of the great challenges of translating discoveries to clinical care to optimize patient outcomes. In particular, nonadherence to lifesaving medications continues to trouble health care systems. We conducted a series of studies to investigate why cardiac patients stop life-sustaining medications and to develop a tool to proactively address medication adherence issues. We could find no available preventive tools for communicating with patients about their medications in the clinical setting. In this article, we summarize the process of developing such a tool. ⋯ Patient interviews revealed that patients' values and beliefs, barriers to treatment, and prior medication-taking behavior were of primary importance in understanding medication discontinuance. Pilot testing, expert panel review, and an implementation feasibility evaluation resulted in an 11-item communication guide to be used in a variety of health care settings. Clinicians need an efficient way of systematically communicating with patients about heart medications to identify barriers and to initiate preventive interventions when patients report barriers or challenges to medication adherence.