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Background: Hypoplastic left heart syndrome (HLHS) was one of the highest mortality congenital heart defects; however, children with HLHS are living longer with medical and technological advancements. This reality resulted in an increased need for primary palliative care. Nurses assume a direct role in providing care to this specific population. Methods: The literature review from PubMed and CINHAL included key terms primary palliative care, pediatric palliative care, pediatric cardiology, HLHS AND nursing care, the role of the pediatric nurse, and pediatric palliative care education. Articles focusing on children with HLHS, pediatric palliative care, the nursing role, pediatric palliative care education, and parental perspectives were included. Articles with a focus on adults with congenital heart disease were excluded. Results: Thirty-three sources were selected for the final review. Palliative care has grown, specializing in children's care. Cardiology providers could improve upon integrating primary palliative care into practice compared to other pediatric specialties. This integration would enhance the quality of life for children with HLHS. Nurses who work with this population are essential in providing this type of care, and require proper education and training. Discussion: After reviewing the articles, it was evident that the nurse's role is crucial in providing primary palliative care to children with HLHS to maintain their quality of life. However, a gap in the literature exists, warranting further research on this topic. Findings in this article suggest that conducting and implementing research and relevant education might provide a better understanding of primary palliative care and its impact on children with HLHS. [ABSTRACT FROM AUTHOR]

This paper addresses the challenge of integrating wearable activity trackers (WATs) into cardiovascular disease care. Despite evidence supporting the use of trackers for monitoring and promoting physical activity, implementation challenges persist in clinical settings. The paper emphasizes the lack of systematic, evidence-based implementation approaches for integrating trackers. It underscores the urgent need for stakeholder collaboration between clinicians, patients, implementation scientists, researchers, health and technology partners, and the use of proven implementation science methodologies. This is crucial for bridging the gap and ensuring effective translation of WATs into cardiovascular care, meeting the increasing demand from patients and clinicians. [ABSTRACT FROM AUTHOR]

Cardiovascular studies, including nursing research, frequently integrate biomarkers for diagnostic, prognostic, monitoring, and therapeutic insights. However, effective utilization of biomarker data demands careful consideration. In the study design phase, researchers must select biomarkers that align with study objectives while considering resources and logistical factors. Additionally, a nuanced understanding of disease pathophysiology and biomarker characteristics is needed. During data collection, suitable experimental conditions and assays need to be defined. Whether researchers opt to manage these steps internally or outsource some, a comprehensive understanding of biomarker selection and experiments remains crucial. In this article, part 1 of 2, we provide an overview of considerations for the design to measurement phases of biomarker studies. [ABSTRACT FROM AUTHOR]

An editorial is presented on the evolution of cardiovascular nursing research published in the "European Journal of Cardiovascular Nursing," including the increasing global distribution of research submissions and the evolving geographical representation of contributing countries over time.

Background: The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. Methods: A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. Results: The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. Conclusions: The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap. [ABSTRACT FROM AUTHOR]

The article examines the relationship between echocardiographic parameters and Galectin-3 levels in patients with atrial fibrillation (AF) as markers of left atrial fibrosis. Topics discussed include the use of speckle-tracking echocardiography (STE) to assess atrial fibrosis, serum Gal-3 levels, and their correlations with echocardiographic parameters in both permanent and paroxysmal AF patients, emphasizing the potential integration of biomarkers into cardiovascular care practices.

Purpose: To identify nursing interventions for the management of adult patients undergoing cardiotoxic oncologic therapy. Methods: This scoping review was performed in accordance with the JBI guidelines. The literature search took place between July and August 2022. Studies examining interventions for the management of adult cancer patients undergoing cardiotoxic therapy were included. The characteristics and results of the studies were synthesized and analyzed in a narrative way. Findings: In the nine included studies, it was verified that the interventions were implemented to guide the actions of the health team in general rather than specifically nursing staff. Nine nursing interventions related to the Classification of Nursing Interventions were included. Conclusions: The nursing interventions identified focused on rigorous cardiovascular surveillance, risk assessment, and actions to identify and mitigate cardiotoxicity. Implications for Nursing Practice: It is believed that the implementation of the identified nursing interventions will lead to evidence‐based nursing practice and will contribute to the development of care products and processes that assess the cardiological risks and cardiotoxicity. [ABSTRACT FROM AUTHOR]

Large language models (LLMs) such as ChatGPT have emerged as potential game-changers in nursing, aiding in patient education, diagnostic assistance, treatment recommendations, and administrative task efficiency. While these advancements signal promising strides in healthcare, integrated LLMs are not without challenges, particularly artificial intelligence hallucination and data privacy concerns. Methodologies such as prompt engineering, temperature adjustments, model fine-tuning, and local deployment are proposed to refine the accuracy of LLMs and ensure data security. While LLMs offer transformative potential, it is imperative to acknowledge that they cannot substitute the intricate expertise of human professionals in the clinical field, advocating for a synergistic approach in patient care. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To gain a greater understanding of key specialist nursing roles in children’s cardiology • To delve into the guidance and standards on nursing roles and competences in children’s cardiac services • To recognise the need for nursing teams to collaborate across congenital heart disease (CHD) networks. Background: Children’s cardiac nursing roles have changed over the past decade. Royal College of Nursing (RCN) guidance and NHS England standards have been published with the aim of standardising and enhancing nursing care for children and young people with congenital heart disease (CHD) and their families. Aim: To explore the breath of implementation of key nursing roles in children’s cardiac services across the UK and Ireland and to determine whether the roles met the RCN guidance and the NHS England standards. Method: A cross-sectional survey design was used. The 150 members of the Congenital Cardiac Nurses Association (CCNA) were invited via email to participate and were sent a link to an online survey. Findings: Of the 150 potential respondents, 31 completed the survey. Overall, respondents believed that the RCN guidance had been implemented effectively and that children’s cardiac nursing roles matched the RCN’s example job descriptions. Respondents’ comments suggested that implementation of the NHS England standards had been challenging and that progress in setting up key roles such as lead nurse, cardiac nurse educator and children’s cardiac nurse specialist had been slow. Respondents felt that political and financial factors adversely affected recruitment. Conclusion: Since publication of the NHS England standards there has been some progress in the implementation, in children’s cardiac services, of key nursing roles such as lead nurse and innovative nursing roles such as advanced nurse practitioner and research nurse. The findings of this study have informed the latest edition of the RCN guidance, which now includes the role of senior research nurse. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy (HDP) are maternity-related increases in blood pressure (eg, gestational hypertension, preeclampsia, and eclampsia). Compared with women of other races in high-income countries, Black women have a comparatively higher risk of an HDP. Intersectionality helps to provide a deeper understanding of the multifactorial identities that affect health outcomes in this high-risk population. Objective: In this review, we sought to explore the literature on HDP risk factors in Black women living in high-income countries and to assess the interaction of these risk factors using the conceptual framework of intersectionality. Methods: We conducted this review using the Arksey and O'Malley methodology with enhancements from Levac and colleagues. Published articles in English on HDP risk factors with a sample of not less than 10% of Black women in high-income countries were included. Six databases, theses, and dissertations were searched from January 2000 to July 2021. A thematic analysis was used to summarize the results. Results: A final total of 36 studies were included from the 15 480 studies retrieved; 4 key themes of HDP risks were identified: (1) biological; (2) individual traditional; (3) race and ethnicity, geographical location, and immigration status; and (4) gender related. These intersectional HDP risk factors intersect to increase the risk of HDP among Black women living in high-income countries. Conclusion: Upstream approaches are recommended to lower the risks of HDP in this population. [ABSTRACT FROM AUTHOR]

A virtual-reality-simulation-based nursing education program incorporating an information processing model helps nursing students develop their learned knowledge as nursing behavior and develop their ability to cope with complex clinical challenges. The purpose of this study is to develop a nursing education program using an immersive virtual reality simulation app for clinical situations based on an information processing model and identify the effects. A non-quantitative control group pretest–post-test design was employed. The programs were developed using the ADDIE model and an information processing model. In order to verify the effectiveness of the program, six adult nursing learning issues were taught to the experimental group over 6 weeks. The nursing education program in this study provides comprehensive experiential learning through advanced virtual simulation, significantly enhancing nursing students' performance confidence, critical-thinking abilities, and problem-solving skills across a wide range of clinical scenarios. By repeatedly engaging with diverse learning topics related to adult nursing, this program not only equips students with essential practical skills but also contributes to the overall improvement of patient safety and the quality of medical care. [ABSTRACT FROM AUTHOR]

Introduction: Bedside nurses in the intensive care units are exposed to multiple challenges in their regular practice and recently have taken in ventricular assist device care in Lebanon since its introduction as a fairly new practice. Objectives: To explore the experiences of nursing staff who work in Lebanese hospitals with Left Ventricular Assist Devices (LVAD). Methods: This study employed a qualitative phenomenological research design, where semi-structured interviews were carried out among fifteen LVAD nurses in an acute care hospital. Results: The qualitative data analysis produced six main themes. The first theme prevalent was "LVAD incompetence and shortage" and it reflected the deficit in properly structured training and the number of specialized LVAD nurses. The second theme that resulted from the analysis was titled, "Patient and family knowledge", which indicated the misconceptions that families and patients usually hold about LVAD which usually sugarcoats the situation. This was followed by "Burden of complications", "LVAD patient selection", "Perception of the LVAD team as invulnerable", and "High workload and patient frailty" which reflected the perspectives of LVAD nurses. Conclusion: This study shows that the Lebanese LVAD nurses who participated in this study perceived inadequate competence, yet lacked proper training and induction. The nurses reported multiple challenges relating to care tasks, workload, and patient and family interactions which need to be addressed by coordinators. [ABSTRACT FROM AUTHOR]

Aims Clinical guidelines recommend people with heart failure are managed within a multidisciplinary team to receive optimal evidence-based management of the syndrome. There is increasing evidence that Nurse Practitioners (NP) in heart failure demonstrate positive patient outcomes. However, their roles as key stakeholders in a multidisciplinary heart failure team are not clearly defined. The aim of the review was to explore the literature related to NP-sensitive outcomes in heart failure. Methods and results A scoping review was conducted according to accepted guidelines using the Joanna Briggs Institute framework for conducting a scoping review, to identify the literature that related to NP-sensitive outcomes in heart failure management. Sixteen texts were selected for data extraction and analysis. The most common outcome measures reported were readmission rates, self-care measurement scales, functional status scores, quality of life measurements, and medication optimization outcomes. No two studies collected or reported on the same outcome measurements. Conclusion This review highlights that the reporting of heart failure (HF) NP outcome indicators was inconsistent and disparate across the literature. The outcome measures reported were not exclusive to NP interventions. Nurse Practitioner roles are not clearly defined, and resulting outcomes from care are difficult to characterize. Standardized NP-specific outcome measures would serve to highlight the effectiveness of the role in a multidisciplinary HF team. [ABSTRACT FROM AUTHOR]

Background: Standardized nursing measures are series of nursing interventions and practices that help in decreasing pulmonary atelectasis after open heart surgeries. Aim: the current study aimed to evaluate the effect of implementing standardized nursing measures on prevention of pulmonary atelectasis among patients undergoing open heart surgeries. Subjects and Method: Design: Quasi-experimental study design. Setting: this study was performed at Surgical Intensive Care Unit at Tanta International Teaching Hospital affiliated to Ministry of High Education and Scientific Research. Subjects: A purposive sample of 80 adult conscious patients admitted to the previously mentioned setting and was selected and divided to two equal groups 40 patients in each. Tools: Tool I: Open Heart Surgery Patients’ Assessment Tool, tool II: Pulmonary Atelectasis Assessment Tool. Results: In relation to signs of atelectasis, it was observed that most of the study sample (75%) and less than half (40%) of the control group didn’t have cough during the first and the fifth postoperative day, respectively. Regarding to sings of dyspnea it was observed that 5% of patients and more than half 52.5% of the control group had mild dyspnea during the fifth post-operative day. Conclusion: It can be concluded that implementation of standardized nursing measures techniques decreased signs of postoperative pulmonary atelectasis. Recommendations: It can be recommended that standardized nursing measures should be implemented for patients post heart surgeries to prevent pulmonary atelectasis. [ABSTRACT FROM AUTHOR]

Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, also referred to as STA-MCA bypass, is a direct revascularisation treatment for moyamoya disease. Moyamoya disease is a rare cerebrovascular condition characterised by progressive narrowing of the distal segments of the internal carotid arteries. Untreated, this may cause varied and progressive symptoms for patients, with a significantly increased risk of stroke annually. STA-MCA bypass is performed several times a year at Royal North Shore Hospital by specialist cerebrovascular neurosurgeons. This is a quaternary service with patient referrals received from throughout Australia. This paper will provide an overview of moyamoya, the surgical treatment and nursing care. The pre- and post-procedure nursing care for these patients is paramount, including perioperative blood pressure management, neurological assessment and wound care. The paper will also explore a case study of a patient who underwent a STA-MCA bypass, highlighting the value of specialised neuroscience nursing care, and additional considerations when managing patients living at a distance from the local health district. [ABSTRACT FROM AUTHOR]

Local problem: Sternal wound infections (SWIs), whether superficial or deep, are associated with increased morbidity, mortality, and costs. From 2016 to 2017, our facility saw a 50% decrease in SWIs among patients undergoing cardiothoracic surgery with sternotomy. From 2017 to 2018, however, we identified a 33% increase in SWIs, prompting us to address our cardiac nurses' sternal wound care education and practice. Purpose: The purpose of our quality improvement (QI) project was to identify opportunities for improvement in postoperative sternal incision care and to implement evidence-based processes to reduce the incidence of SWIs among cardiothoracic surgery patients. Methods: A literature review was performed to identify interventions focused on evidence-based SWI reduction. During the first quarter of 2019, our postoperative incision care guidelines were revised and released to staff, a new surgical wound cleansing product was supplied, and RN education was provided. Cardiac nurses were surveyed in April 2019 to identify any remaining knowledge and practice deficits and to assess their adherence to the new guidelines. The survey responses helped us to further improve our nurse education. We also provided periodic nurse reeducation and enhanced patient and family education. All such interventions were implemented by the end of June 2019. Results: Between January and June 2019, we had one SWI. From July 2019 through December 2020, an 18-month period, we experienced zero SWIs. Although beginning in 2021, we saw an increase in SWIs—four in 2021 and five in 2022—our incidence rates remain below 0.5% and we continue to work toward an SWI goal of zero. Conclusion: This QI project identified opportunities for improvement, implemented evidence-based strategies for wound care and education, and successfully achieved a zero SWI rate for a period of 18 months. This quality improvement project aimed to identify opportunities for improvement in postoperative sternal incision care and to implement evidence-based methods to reduce the incidence of sternal wound infections among cardiothoracic surgery patients. [ABSTRACT FROM AUTHOR]

Aims This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it. Methods and results The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive. Conclusion Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes. Registration PROSPERO: CRD42022355669 [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article explores the use of Abdellah's Nursing Process in patient care with extracorporeal membrane oxygenation (ECMO). ECMO is a treatment used for patients with cardiopulmonary failure and acute respiratory distress syndrome. The article highlights the importance of a multidisciplinary approach and the use of nursing theories to enhance care practices. Abdellah's 21 Nursing Problem Theory is presented as a suitable model for addressing the needs of patients undergoing ECMO. The article includes a case report that demonstrates the implementation of Abdellah's approach in patient care, focusing on nursing diagnoses and interventions related to basic care needs, sustenance care needs, and restorative care needs. The article concludes that Abdellah's theory can effectively meet the nursing care needs of patients undergoing ECMO. [Extracted from the article]

Background: Coronary artery disease (CAD) is the leading cause of cardiovascular morbidity, mortality, and healthcare costs in the United States. There are few reports on how public health and payment reforms might have influenced inpatient hospital use among patients with CAD. Objective: This study describes trends in hospital discharges, hospital charges, and discharge destinations in a national sample of patientswith CAD between 1997 and 2014.Methods: This was a longitudinal study with descriptive analysis of the Healthcare Cost and Utilization Project of National Inpatient Sample data. Findings: During this study period, the total number of discharges was 1333996. Patients with CAD between 65 and 84 years old were among the highest users of inpatient hospital services, followed by those in the 45- to 64-year age group. The death rate increased from 5961 to 7217 per 10000 patients during this time. The mean charge increased more than 5 times, from $9100 to $49643. There was a large difference in mean hospital charges in urban ($51666) and rural ($25548) locations in 2014. Coronary artery disease patientswith private insurance paidmore than those with Medicaid and Medicare plans. The discharge to home and healthcare costs increased by 4.1%and 4. 8%, respectively. Conclusion and Implications: Future researchers should use data sets, such as Medicare claims/Medical Expenditure Panel Study, that can provide comprehensive insights into patient-level factors influencing the use of inpatient care services among patients with CAD. Healthcare providers in posthospital settings should be well skilled in providing advanced cardiac rehabilitation and education to patients with CAD. [ABSTRACT FROM AUTHOR]

Background: Mutuality, defined as "the positive quality of the relationship between a caregiver and a care receiver", was found to be associated with self-care and caregiver contribution to self-care in heart failure (HF). However, no studies were conducted to evaluate whether motivational interviewing (MI) can improve mutuality in patients with HF and caregivers. Objectives: The aim of this study was to evaluate the effectiveness of MI on mutuality in HF patient-caregiver dyads. Methods: This is a secondary outcome analysis of the MOTIVATE-HF randomized controlled trial, the primary aim of which was to evaluate the effect of MI on improving self-care in patients with HF. Participants were randomized into 3 arms: (1)MI for patients only, (2)MI for both patients and caregivers, and (3) standard care. To assess the HF patients' and caregivers' mutuality, the Mutuality Scale was used in its patient and caregiver versions. Results: Patients with HF had a median age of 74 years, and there were more men (58%). Most patients were retired (76.2%). Caregivers had a median age of 55 years and were mostly women (75.5%). Most patients were in New York Heart Association class II (61.9%) and had an ischemic HF etiology (33.6%). The motivational interviews did not show any impact on changes in the patient and caregiver mutuality during the follow-up time (3, 6, 9, and 12 months from baseline). The condition of living together between the patient and the caregiver was significantly associated with better mutuality between the patient and the caregiver. Conclusions: Motivational interviewing performed by nurses was not effective in improving mutuality in patients with HF and caregivers, but the target variable of the intervention was patient self-care. Stronger effects of MI on mutuality were observed in patients with HF and caregivers who live together. Future studies should target mutuality to see whether MI is really effective. [ABSTRACT FROM AUTHOR]

Background: There is limited research exploring the behavioral intentions, beliefs, and application of theoretical models in relation to self-care in patients with atrial fibrillation (AF). Objective: This study aimed to identify the factors that influence self-care behavior in patients with AF. Methods: The study used an integrated behavioral model and collected data from 216 patients diagnosed with AF. Data were analyzed using SPSS 24.0 and AMOS/WIN 24.0 to verify the fit of the hypothesis model, confirm factor analysis, and the validity of the hypothesis itself. Results: Self-care behavioral intention (β = 0.433, p <.001) and habit (β = 0.395, p =.005) had a significant direct effect, while instrumental attitude (β = 0.077, p =.045), injunctive norm (β = 0.084, p =.037), and self-efficacy (β = 0.249, p =.011) had a significant indirect effect on self-care behavior, explaining 64.4% of the variance. Conclusion: The final model validated the factors that impact self-care behavior in patients with AF, highlighting the importance of fostering positive recognition of instrumental attitude, bolstering social influence and self-efficacy through significant individuals to improve self-care behavior. It is recommended to create an intervention program that encourages intentions and motivations for self-care behavior and incorporates tactics to make self-care behavior a habit. The study's path diagram can serve as a conceptual framework for designing strategies to enhance self-care behavior in patients with AF. [ABSTRACT FROM AUTHOR]

The article delves into the multifaceted benefits of scientific conferences, highlighting their crucial role in knowledge dissemination, career advancement, and interdisciplinary collaboration.

An editorial is presented on nurse-led interventions in cardiovascular care, highlighting their impact on patient empowerment, self-management, and healthcare outcomes, including the evolution and significance of nurse-led care and the role of nurses in patient education and self-management.

The article focuses on the journey of transitioning from a career in the NHS, spanning critical care, cardiac nursing, and primary care, to becoming an independent nurse, driven by a passion for cardiology and education, eventually leading to a decision to leave management roles due to disillusionment and a desire to return to direct patient care.

The article focuses on benefits of national cardiology societies affiliating with the Association of Cardiovascular Nursing and Allied Professions (ACNAP), including the enhancement of professional growth opportunities and the promotion of collaborative networks for improving cardiovascular care.

The article focuses on the transformative potential and ethical considerations of integrating large language models (LLMs) into nursing practice.

Alison Pottle, Consultant Nurse, Cardiology, Harefield Hospital, London (A.Pottle@rbht.nhs.uk), was the winner of the Silver Award in the Cardiovascular Nurse of the Year Category in the BJN Awards 2023 [ABSTRACT FROM AUTHOR]

A personal narrative is presented which explores the author's experience of nursing a nun patient who has been receiving hospice care and was nearing the end of her life.