K Smith

Nurse specialists in adult congenital heart disease: The current status in Europe

Aim: Recommendations for the management of adults with congenital heart disease indicate that specialist referral centres should employ nurse specialists who are trained and educated in the care for these patients. We surveyed the involvement, education and activities of nurse specialists in the care for adults with congenital cardiac anomalies in Europe. Methods: The Euro Heart Survey on Adult Congenital Heart Disease has previously showed that 20 out of 48 specialist centres (42%) have nurse specialists affiliated with their programme. Fifteen of these 20 centres (75%) validly completed a web-based survey tool. Results: Specialist centres had a median number of 2 nurse specialists on staff, corresponding with 1 full-time equivalent. In most centres, the nurse specialists were also affiliated with other cardiac care programmes, in addition to congenital heart disease. The involvement of nurse specialists was not related to the caseload of inpatients and outpatient visits. Physical examination was the most prevalent activity undertaken by nurse specialists (93.3%), followed by telephone accessibility (86.7%), patient education (86.7%), co-ordination of care (73.3%), and follow-up after discharge (73.3%). Patient education covered mainly prevention and prophylaxis of endocarditis (100%), cardiovascular risk factors (92.3%), sport activities (92.3%), the type and characteristics of the heart defect (92.3%), the definition and aetiology of endocarditis (84.6%), cardiac risk in case of pregnancy (84.6%), and heredity (84.6%). Two third of the nurse specialists were involved in research. Conclusion: This survey revealed gaps in the provision of care for these patients in Europe and demonstrated that there is room for improvement in order to provide adequate chronic disease management. The results of this study can be used by individual hospitals for benchmarking.

European cardiovascular nurses attitudes and experiences of having family members present in the resuscitation room

the problem-solving process are central. An integration of different areas of knowledge, theoretical as well as clinical can be used. Motivation can be seen as an important factor for adherence. Drieschner et al (2004) have described 6 internal determinants for treatment motivation; problem recognition, level of suffering, external pressure, perceived cost of treatment, perceived suitability of treatment, and outcome expectancy. These determinants as well as Selfdetermination theory (Decci & Ryan 2000) have been used as the base to develop an educational program using PBL to create motivation to engage in CPAP treatment.

Predicted impact on Victoria's ambulance services of a new major trauma system.

Background: u2003 In 1999, a new major trauma system was proposed for the state of Victoria, Australia. The guidelines for the new system were aimed at delivering major trauma cases to definitive trauma care in the least time possible. The aim of the present study was to analyse the potential effect of this system on Victoria’s ambulance services.

1304: Treatment and health status in patients with proven coronary artery disease, but ineligible for revascularization. A report from the Euro Heart Survey on revascularization

index below 25 and between 25 and 30 (P <0.001). Significant increase in VO2 max for body mass index superior at 30 (P >0.05). High significant increase in VO2 max for left ventricular ejection fraction FEVG>54 (P <0.001) and high significant for FEVG between 30 and 54 (P <0.01). For FEVG below 30, VO2 max didn’t increase significantly (P >0.05) but number of subjects was small (n =4). The increase in VO2 max was higher between 30 and 60 sessions or 100 and 200 days of rehabilitation (P <0.001) because the training was regular and sustained. After supervised rehabilitation, patients are encouraged to continue exercise training. A little more than one third of the patients continued the exercises regularly once or twice a week. Improvement was maintained in proportion to the intensity of the training. This was not influenced by patients’ age. Conclusions: A regular and supervised rehabilitation program after cardiac diseases allows to obtain a clinical relevant increase in VO2 max. The gains in physical capacity is observed at all ages, independently of sex and of BMI, for all FEVG. These results encourage us in insisting that patients follow regular long term exercise.