Outcomes of nurse practitioner-led care in patients with cardiovascular disease: A systematic review and meta-analysis

J Adv Nurs. 2020 Jan;76(1):81-95. doi: 10.1111/jan.14229. Epub 2019 Oct 24.

Abstract

Aim: To assess randomized controlled trials evaluating the impact of nurse practitioner-led cardiovascular care.

Background: Systematic review of nurse practitioner-led care in patients with cardiovascular disease has not been completed.

Design: Systematic review and meta-analysis.

Data sources: The Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, Web of Science, Scopus and ProQuest were systematically searched for studies published between January 2007 - June 2017.

Review methods: Cochrane methodology was used for risk of bias, data extraction and meta-analysis. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation approach.

Results: Out of 605 articles, five articles met the inclusion criteria. There was no statistical difference between nurse practitioner-led care and usual care for 30-day readmissions, health-related quality of life and length of stay. A 12% reduction in Framingham risk score was identified.

Conclusion: There are a few randomized control trials assessing nurse practitioner-led cardiovascular care.

Impact: Low to moderate quality evidence was identified with no statistically significant associated outcomes of care. Nurse practitioner roles need to be supported to conduct and publish high-quality research.

目的: 在于评估随机对照试验,从而评估执业护士主导型护理心血管护理的影响。 背景: 尚未完成对心血管疾病患者进行执业护士主导型护理的系统综述。 设计: 系统综述和荟萃分析。 资料来源: 在 Cochrane Central Register of Controlled Trials (CENTRAL)、Medline、Embase、CINAHL、Web of Science、Scopus和ProQuest上系统地搜索了2007年1月至2017年6月间发表的研究。 综述方法: Cochrane方法学用于偏倚风险、数据提取和荟萃分析。证据质量的评估采用了GRADE(Grading of Recommendations Assessment, Development and Evaluation)法。 结果: 在605篇文章中,有5篇符合纳入标准。执业护士主导型护理和30天再度入院的常规护理、健康相关生活质量和住院天数之间没有统计学差异。确定Framingham 风险评分降低了12%。 结论: 有一些随机对照试验评估了执业护士主导型心血管护理。 影响: 确定了低等至中等质量的证据,没有统计学意义的相关护理结果。需要支持执业护士的角色,从而开展和发布高质量研究。.

Keywords: cardiovascular care; clinical intervention; meta-analysis; nurse; nurse practitioner; outcomes of care; randomized control trial; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Cardiovascular Diseases / nursing*
  • Humans
  • Nurse Practitioners*
  • Outcome Assessment, Health Care*
  • Randomized Controlled Trials as Topic