Implementation of the cardiovascular assessment screening program (CASP) by nurse practitioners-it's time to focus on early identification of cardiovascular risk

• Published in: European Journal of Cardiovascular Nursing
• Main Authors: Bruneau, J, Moralejo, D, Parsons, K, Donovan, C
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press (OUP) 2022
• Subjects: Advanced and Specialized Nursing; Medical–Surgical Nursing; Cardiology and Cardiovascular Medicine; Canada; Newfoundland
• Online Access: http://dx.doi.org/10.1093/eurjcn/zvac060.088; https://academic.oup.com/eurjcn/article-pdf/21/Supplement_1/zvac060.088/44381487/zvac060.088.pdf

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Newfoundland and Labrador Support for Patient-Oriented Research (NL SUPPORT) Background There is inconsistent utilization of clinical practice guidelines (CPGs) for cardiovascular disease (CVD) screening and management by advanced practice nurses/nurses practitioners (NPs) to identify CVD risk factors early and to intervene using current recommendations. To address this clinical practice issue and increase utilization of Canadian CPGs, an exploratory multiphase sequential mixed methods study was conducted and the Cardiovascular Assessment Screening Program (CASP) was developed, implemented, and evaluated. Objective Phase 2 of the mixed methods study, a cluster randomized controlled trial (cRCT), evaluated the implementation of CASP by NPs with individuals aged 40-74 years, without established CVD or vascular disease (VD), in order to identify CVD risk factors early, to determine the level of risk for a CV event, to calculate the Heart Age, and to set heart health priorities and management, according to current CPGs in Canada. Methods In a cRCT, block randomization randomly divided ten NPs into the intervention group clusters (IGCs) and the control group clusters (CGCs). In turn, eight NPs recruited 166 patients in their own communities; the four NP IGCs recruited patients (n=67) and the four NP CGCs recruited patients (n=99). The web-based CASP intervention was implemented with patients in the IGCs, and the CGCs received standard care. The CASP intervention consisted of four components: an electronic CVD Database, an NP toolkit, an educational resource for NPs and patients, and a website containing CPGs. The data on CVD risk factors, Framingham Risk Score (FRS), Heart Age, and priorities for heart health were recorded in the CVD Database utilized by the NP IGCs. Results Utilizing the CVD database, CVD risk factors were consistently identified in patients by NPs in the IGCs compared to the NP ...