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Background Patients requiring vascular surgery have turned in older subjects with several comorbidities with frailty problems and increased vulnerability. Treating this kind of patients has become an important challenge both for vascular surgeons and for dedicated nurses, as these patients are more susceptible to postoperative complications and during discharge. The aim of this review is to analyze the role of vascular nurse in vascular surgery activities. Methods For this study, Medline, ScienceDirect, and Scopus databases were searched. The following keywords were used: nursing and vascular surgery, nursing and vascular disease, nursing and vascular procedure, and care and vascular patient. Results From the search strategy, the following areas were identified as relevant and analyzed in detail: vascular disease related to vascular surgery, the definition of vascular nursing, the role of vascular nursing in implementing clinical pathways in vascular surgery procedures, nursing postoperative care in vascular surgery, frailty assessment in vascular patient, nursing in phlebology and wound care, and the management of vascular access. Conclusions Vascular nursing is a discipline that is able to provide comprehensive and optimal care, better postoperative outcomes, and coordinated, standardized, and cost-effective clinical pathways for patients managed in the area of vascular surgery.

Although the measurement of ankle-brachial index (ABI) is considered a fundamental skill in assessment and diagnosis of peripheral arterial disease and a predictive tool for cardiovascular events, real-world practice shows that the experience of many health professionals is far from ideal. Not only teaching and practice of ABI measurement in undergraduate medical curricula are limited but various mistakes in the process of calculation, estimation, and interpretation of ABI results in the postgraduate practice have also been documented. Because vascular surgery is a core subject in our medical school, we deal with the difficulties and challenges that undergraduate medical students and nurses face to measure and comprehend ABI. We came up with useful tips and maneuvers to overcome these difficulties. Accordingly, this article provides twelve easy-to-follow useful tips to enhance and facilitate the teaching and comprehension of ABI. Moreover, it favors the simultaneous teaching of Doppler arterial waveform examination as a means to facilitate accurate interpretation and validation of ABI results.

Extravasation and infiltration are among the most common intravenous therapy complications. For noncytotoxic agents, the incidence of extravasation remains unknown. There has been little research into extravasation due to ethical considerations limiting controlled research; most evidences are based on small, uncontrolled trials or case reports. The purpose of this study was to assess the knowledge level regarding noncytotoxic medications extravasation and its associated factors among staff nurses.A descriptive correlational design using self-administered questionnaire was employed. A convenience sample of 387 nurses completed a questionnaire about noncytotoxic medication extravasation. Statistical Package for Social Sciences version 21 was used to analyze data by applying the chi-square test, t test, and the Mann–Whitney test to assess the knowledge difference between open and closed units' nurses.The results indicate that only 19.6% of nurses have a good knowledge about noncytotoxic medications extravasation. There was consistently poor staff knowledge regarding noncytotoxic medications extravasation. Although the closed units' nurses reported relatively higher level of knowledge than open units' nurses, their level of knowledge still inadequate. Health care organizations must consider developing specific policies regarding extravasation. Closed and open units' nurses should be enrolled in special education programs to improve their level of knowledge regarding noncytotoxic medication extravasation.

Information literacy is essential in facilitating evidence-based practice (EBP) activities. In vascular nursing, the implementation of EBP is of utmost importance. Best practice grounded in research evidence can contribute to improved patient care outcomes for individuals with vascular disease. The following paper discusses information literacy competencies for nurses to develop in the context of EBP, with an emphasis on formulating a clinical question and searching for evidence. Relevant health science information resources are described, including their value and purpose in the 6S model of evidence. Also discussed are practical and supportive solutions with proven effectiveness in ensuring nurses' success with EBP.

Introduction Acute chest pain is a common symptom among prehospital emergency care patients. Therefore, it is crucial that ambulance nurses (ANs) have the ability to identify symptoms and assess patients suffering from acute coronary syndrome (ACS). The aim of this study is to explore the occurrence of dyspnoea and nausea and/or vomiting in the prehospital phase of a suspected ACS and the associations with patients' outcome. Methods This study has a quantitative design based on data from hospital records and from a previous interventional study (randomised controlled trial) including five Emergency Medical Service (EMS) systems in western Sweden in the years 2008–2010. Results In all, 1836 patients were included in the interventional study. Dyspnoea was reported in 38% and nausea and/or vomiting in 26% of patients. The risk of death within one year increased with the presence of dyspnoea. The presence of nausea and/or vomiting increased the likelihood of a final diagnosis of acute myocardial infarction (AMI). Conclusion This study shows that dyspnoea, nausea and/or vomiting increase the risk of death and serious diagnosis among ACS patients. This means that dyspnoea, nausea and/or vomiting should influence the ANs' assessment and that special education in cardiovascular nursing is required.

Background The evidence linking nursing care and patient outcomes has been globally demonstrated. Thus, it is time for translation and application of this evidence to robust measurement that uniquely demonstrates the value of nursing care and the characteristics of the nursing workforce that contribute to optimal patient outcomes. Objective The aim of this study was to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. Methods Using a consensus-based approach, the Consortium of Congenital Cardiac Care- Measurement of Nursing Practice (C4-MNP) members developed quality measures within working groups and then individually critiqued all drafted measures. Final draft measures were then independently reviewed and critiqued by an external nursing quality measurement committee. The final quality measures were also made available to a national parent support group for feedback. Outcomes The development process used by C4-MNP resulted in 10 measures eligible for testing across freestanding children's hospitals. Employing a collaborative consensus-based method plus implementing the criteria of the National Quality Forum and external vetting period provided a strong framework for the development and evaluation of standardized measures. Next Steps The Consortium will continue with implementation and testing of each measure in 9 of our 28 collaborating centers. This activity will support initial development of benchmarks and evaluation of the association of the measures with patient outcomes.

There has been an ongoing technological evolution and impact of medical instrumentation on cardiovascular patient care during the last fifty years, and it is now impossible to manage the diagnostic and therapeutic process without adequate instrumental support. This trend has radically modified the professional activity of most healthcare personnel but it has not always been flanked by appropriate professional training. In particular, professional nursing schools are resistant to open their courses to technological aspects and in the rare cases of interest, have major difficulties finding qualified teachers with clinical experience and an aptitude for instrumental procedures

The Society for Vascular Surgery ® (SVS) and the American Venous Forum (AVF) published guidelines for the management of venous leg ulcers in August 2014. The goal of this article (Part 2) is to summarize the guidelines that address diagnosis and treatment recommendations published jointly by the SVS and AVF that may affect the nursing practice of vascular nurses. Specific sections include wound evaluation, therapies used on the wound bed itself, compression, and operative or endovascular management. Part 1, published elsewhere in this issue, addressed the epidemiology and financial impact of ulcers, venous anatomy, pathophysiology of venous leg ulcer development, clinical manifestations, and prevention of venous leg ulcers. These 2 parts together provide a comprehensive summary of the joint SVS and AVF guidelines for care of venous leg ulcers.

Chronic venous disease (CVD) is a complex chronic vascular condition with multifaceted primary and secondary etiologies leading to structural and functional changes in veins and valves and blood flow of the lower legs. As a consequence, a spectrum of clinical manifestations arise, ranging from symptoms of mild leg heaviness and achiness to debilitating pain, and signs of skin changes, such as eczema and hemosiderosis, to nonhealing, heavily draining venous leg ulcers (VLUs). Triggers such as trauma to the skin are responsible for a large majority of VLU recurrences. Diagnostic testing for venous reflux includes ultrasound imaging; unfortunately, there are no diagnostic tests to predict VLUs. The hallmark of treatment of both CVD and VLUs is compression. Leg elevation, exercise, and wound management with dressings and advanced healing technologies that provide an environment conducive to healing should focus on reducing pain, necrotic debris, drainage, and odor, as well as preventing infection. VLUs that become chronic without evidence of healing over a 4-week period respond best to multidisciplinary wound experts within a framework of patient-centered care. Nurses are in key positions to provide early recognition of the signs and symptoms as well as initiate prompt diagnostic and promote early treatment to offset the progression of the disease and improve quality of life.

Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism. Although much is known about risk factors for VTE, there is failure in administration of appropriate prophylaxis to patients who are at risk for VTE. A paper-based reminder system is considered to be among the most effective methods of improving VTE prophylaxis in hospitalized patients. However, their success relies on choosing an evidence-based institutional guideline and implementation of its recommendations. This study was carried out to detect the extent of application of the institutional guideline (Caprini score risk assessment sheet). The study was carried out in the Jordan University Hospital; 354 patients were enrolled in the study and distributed among the following wards: nonorthopedic surgical (n = 119), medical (n = 220), and surgical orthopedic wards (n = 15). The risk assessment sheet was present in only 47.2% of the patient's' files, and the scores in the files were estimated correctly in only 52.1% of cases. Prophylaxis received by patients matched the recommendation of the Caprini score in 67.1% of the patients. The degree of concordance of the VTE prophylaxis with the Caprini score was 59.9%. This study showed that the institutional guideline was poorly implemented in the hospital.

Background We designed and tested an innovative transitional care program, involving cardiac surgery nurse practitioners, to improve care continuity after patient discharge home from coronary artery bypass graft (CABG) operations and decrease the composite end point of 30-day readmission and death. Methods A total of 401 consecutive CABG patients were eligible between May 1, 2010, and August 31, 2011, for analysis. Patient data were entered prospectively into The Society of Thoracic Surgeons database and the New York State Cardiac Surgery Reporting System and retrospectively analyzed with Institutional Review Board approval. The “Follow Your Heart” program enrolled 169 patients, and 232 controls received usual care. Univariate and multivariate analyses were used to identify readmission predictors, and propensity score matching was performed with 13 covariates. Results Binary logistic regression analysis identified “Follow Your Heart” as the only independently significant variable in preventing the composite outcome ( p = 0.015). Odds ratios for readmission were 3.11 for dialysis patients, 2.17 for Medicaid recipients, 1.87 for women, 1.86 for non-Caucasians, 1.78 for chronic obstructive pulmonary disease, 1.26 for diabetes, and 1.09 for congestive heart failure. Propensity score matching yielded matches for 156 intervention patients (92%). The intervention showed a significantly lower 30-day readmission/death rate of 3.85% (6 of 156) compared with 11.54% (18 of 156) for the usual care matched group ( p = 0.023). Conclusions A home transition program providing continuity of care, communication hub, and medication management by treating hospital nurse practitioners significantly reduced the 30-day composite end point of readmission/death after CABG. More targeted resource allocation based on odds ratios of readmission may further improve results and be applicable to other patient groups.

[Figure][1] ![Figure][1] ![Figure][1] ![Figure][1] Cardiovascular disease (CVD) is a major cause of morbidity and premature mortality in women and men worldwide. During the past 2 decades, the prevalence of CVD and stroke has increased and accelerated in low- and

The experience of a cardiac event is a source of stress for both patients and their family members that may be viewed as a family crisis. The trajectory of cardiovascular disease, including both the acute and recovery phases, involves continuous adjustment by patients and family members as they attempt to reconcile the impact of the event and adapt to the uncertainties associated with the chronicity of coronary heart disease. This article reviews empirical intervention research available to practitioners and researchers that may guide the use of family centered cardiovascular nursing interventions. Although a significant amount of research has been conducted in this area, conclusions regarding patient and family interventions are varied. Directions for future research focus on the need for family centered interventions that address the needs of patients with cardiovascular disease that are specific to phases in the trajectory of illness.

publisher: Elsevier articletitle: Regarding “Development of a postgraduate interventional cardiac nursing curriculum” by Currey et al. journaltitle: Australian Critical Care articlelink: http://dx.doi.org/10.1016/j.aucc.2015.12.038 content_type: simple-article copyright: © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

tests of content understanding. These questions will assess knowledge, comprehension and application. Principles of adult learning will be employed during the entirety of the workshop. The core competencies specific to HF as outlined by the CNA Cardiovascular Nursing Examination will be integrated throughout. Completion of this workshop will assist in learner preparation for success on theHF component of the examination.

tests of content understanding. These questions will assess knowledge, comprehension and application. Principles of adult learning will be employed during the entirety of the workshop. The core competencies specific to HF as outlined by the CNA Cardiovascular Nursing Examination will be integrated throughout. Completion of this workshop will assist in learner preparation for success on theHF component of the examination.

attendance, an industry sponsored meal, one hour of paid education time and a certificate of attendance are provided. Our first season ended in May with over 500 nurses attending, usually on their own time. Evaluations have been outstanding, and we have secured funding and support for our second season. In today’s every changing world of cardiovascular nursing we believe our concept of relevant, timely education by frontline nurses for frontline nurse is a concept that is easily transferable to any setting.

attendance, an industry sponsored meal, one hour of paid education time and a certificate of attendance are provided. Our first season ended in May with over 500 nurses attending, usually on their own time. Evaluations have been outstanding, and we have secured funding and support for our second season. In today’s every changing world of cardiovascular nursing we believe our concept of relevant, timely education by frontline nurses for frontline nurse is a concept that is easily transferable to any setting.

9 Chapter One: Introduction 10 The Exercise Tolerance Test 10 Background 12 The ETT Nursing Role 13 Development of Advanced Nursing Roles in New Zealand 13 Advancing Cardiovascular Nursing Roles and Role Expansion 15 The Research Question 16 Summary 17 Chapter Two: Literature Review 18 Introduction 18 Search Strategy 18 Historical Development of the ETT Nurse 19 Advancing Cardiovascular Nursing and Role expansion 27 Literature Discussion 32 Summary 35 Chapter Three: Methods 36 Interviews with ETT Nurses 37 Method 37 Participants 37 Data Collection 38 Ethical Issues 38 Data Analysis 39 Interview with Clinical Director of Cardiology 40

Editor's note: I am pleased to have the opportunity to publish this special issue on Congenital Heart Diseases as it provides the readership with the most current information on the management of CHD. I want to thank Dr. Sally Higgins for putting together such an excellent issue on pediatric and adolescent cardiovascular nursing.