The Journal of cardiovascular nursing
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This article summarizes the development and implementation of a registered nurse-initiated protocol to intervene with hospitalized patients who are tobacco-dependent, may be experiencing tobacco withdrawal, and who are hospitalized in a smoke-free environment. ⋯ The tobacco use intervention protocol has become important for providing assessment and intervention to patients who use tobacco. It has increased the number of specialist consults provided to patients. It has increased compliance with quality reporting data by national quality accrediting bodies.
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We investigated the impact of perioperative complications on patients' health-related quality of life (HRQL) and intermediate-term survival after cardiac surgery. Improved results for cardiac surgery are well demonstrated in low rates of operative mortality and morbidity. However, the association between perioperative morbid events, HRQL at 1 year, and survival is unclear. ⋯ Patients experiencing 1 or more perioperative complication or increased length of stay reported similar HRQL scores as patients with no complications. Patients with negative changes in social (94.5% vs 99.2%, P < .001) and general health perception (99.4% vs 95.5%, P < .001) domains showed a reduced survival compared with patients with positive HRQL gains at 2 to 5 years after surgery. Perioperative complications had minimal or no effect on HRQL at 1 year after cardiac surgery.
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Coronary heart disease remains the leading cardiovascular cause of mortality and morbidity globally. Implementing evidence-based guidelines after a coronary event is vital to prevent recurrence of an acute episode. However, various barriers to guideline implementation have been identified. ⋯ Despite CR coordinators having positive attitudes toward implementing evidence-based guidelines, several patient-related barriers were identified that obstructed the implementation process. The findings have important implications for nursing practice in terms of directing efforts at increasing participation in CR and engaging commitment of the patient to behavior change. Changes to health service policies that address identified barriers could further facilitate the provision of evidence-based care to patients with coronary heart disease.
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Hospitalized heart failure (HF) patients experience high rehospitalization rates. Predicting early rehospitalization risk in HF patients may enable better decision making at time of hospital discharge. It is known that sex and ethnicity influence rehospitalization rates. Several measures easily and conveniently obtained before discharge are arterial oxygen saturation (SaO2) and distance walked during the 6-minute walk test (6MWT). ⋯ Although there was no relation between SaO2 and rehospitalization risk, women had a greater risk of rehospitalization, were more frail, and were more often anemic. This study is novel because it establishes a link between sex, anemia, functional status, and rehospitalization risk in patients hospitalized for HF. More research is needed to better understand the influence of anemia, functional status, and sex in relation to rehospitalization risk.
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Cardiac arrest, as a result of ventricular fibrillation or pulseless ventricular tachycardia, is a common phenomenon, and the only treatment available is defibrillation. Currently, defibrillators deliver either a monophasic or biphasic shock, depending on the device used. ⋯ These guidelines created a platform to address misconceptions that exist in the practice setting with regard to the use of biphasic defibrillators. The purpose of this literature review was to highlight the issues related to the practical use of biphasic energy, including optimal energy selection and safety.