Key result
Specialist nurse-led care matches physician-led care for mortality and admissions while improving self-care behaviors.
Why the study?
Specialist nurses remain underutilised in heart failure care, and existing systematic reviews comparing advanced nursing roles to physician-led care have not focused solely on heart failure.
Does specialist and advanced nurse-led care improve clinical outcomes, quality of life, and satisfaction in people with heart failure compared to physician-led care?
Does specialist and advanced nurse-led care improve clinical outcomes, quality of life, and satisfaction in people with heart failure compared to physician-led care?
Specialist and advanced nurse-led care appears to be as safe and effective as physician-led care for heart failure patients, with potential benefits in self-care behaviors, though high-quality evidence is limited.
Answers are grounded in this paper and cite their sources.
May support greater specialist nurse integration in HF teams; leaves open need for HF-specific evidence to guide practice.
BACKGROUND: The inclusion of specialist nurses in multi-disciplinary teams is the current gold standard for care of people with heart failure (HF) in the UK; however, they remain underutilised in practice. Though existing systematic reviews favourably compare advanced nursing roles to physician-led care, none has focused solely on HF. AIM: To investigate the impact of specialist and advanced nurse-led care on the clinical outcomes, quality of life and satisfaction of people with HF compared to physician-led care. METHODS: Literature review and narrative synthesis. RESULTS: This review included 12 studies and categorised their measured outcomes into five domains: mortality; hospital admissions and length of stay; HF diagnosis and management; quality of life and patient satisfaction; and finally, self-assessment and self-care. Five studies appraised as medium or low risk of bias suggest the impact of specialist and advanced-level nurses on people with HF to be broadly equivalent to physicians regarding mortality, hospital admissions and length of stay, while superior in terms of self-assessment and self-care behaviours. CONCLUSIONS: There were too few studies of sufficient methodological quality to draw definitive conclusions. However, no evidence was found to suggest that nurse-led services are any less effective or safe than physician-led services.
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Anderson et al. (2020) conducted a review in Heart failure (n=12). Specialist and advanced nurse-led care vs. Physician-led care was evaluated on Mortality, hospital admissions and length of stay, HF diagnosis and management, quality of life and patient satisfaction, and self-assessment and self-care. Specialist and advanced nurse-led care was broadly equivalent to physician-led care for mortality and hospital admissions, and superior for self-assessment and self-care behaviors.
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