Nurse Navigators Aid Outcomes After Heart Attack Discharge

Use of nurse navigators can improve care coordination and outcomes following hospitalization for an acute myocardial infarction (AMI), according to a study presented at the American College of Cardiology Cardiovascular Summit, held from Feb. 14 to 16 in Orlando, Florida.

William E. Downey, M.D., from the Sanger Heart & Vascular Institute in Charlotte, North Carolina, and colleagues evaluated the before and after outcomes associated with implementation of a Heart Care Navigation Team intended to optimize AMI care transitions. The nurse navigator focuses on education, care coordination, and quality improvement, including timely access to follow-up care, promoting self-management, and addressing patients' questions or concerns for a 90-day period.

The researchers found that from reimplementation to postimplementation, there was a reduction in AMI 30-day readmissions (6.3 versus 3.7 percent), a reduction in AMI 30-day mortality rate (5.75 versus 4.57 percent), and an increase in AMI patients' follow-up appointments made prior to discharge (78 versus 96 percent). Additionally, the investigators also observed an increase in guideline-based care (83.3 versus 85.1 percent) and cardiac rehabilitation referrals (85.7 versus 88.6 percent).

"Before the program was implemented, the discharging nurse would provide discharge education, cardiac rehab would provide education, and the patient would be sent on their way," Amber Furr, B.S.N., R.N., performance improvement coordinator at the Sanger Heart & Vascular Institute, said in a press release from the American College of Cardiology. "This study shows that nurse navigators are an integral part of reducing heart attack readmission and mortality."

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