National Survey Finds That 14% Of Primary Care Nurses Have Never Undertaken Any Type Of Basic Training In Cardiovascular Disease, UK

Main Category: Nursing / Midwifery
Also Included In: Cardiovascular / Cardiology
Article Date: 25 Jul 2008 - 2:00 PDT

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More than 1 in 10 primary care nurses lack even basic training in cardiovascular disease (CVD), and nearly a third (28%) said they were not comfortable seeing patients with CVD, in a major survey of the practice nursing profession.

The Nursing in Practice - Omron Survey, of more than 800 primary care nurses, by the journal Nursing in Practice (www.nursinginpractice.com) revealed that 14% had never undertaken any type of basic training in cardiovascular disease, an ongoing and ever-increasing burden on the modern health service.

Heart and circulatory diseases are the UK's biggest killer. In 2004, CVD caused 37% of deaths in the UK, and killed over 216,000 people.1 And every day in the UK there are 350 preventable strokes or heart attacks due to high blood pressure.

And then there are the associated conditions, such as diabetes and obesity, rarely out of the health media headlines.

Marilyn Eveleigh, consultant editor of Nursing in Practice, was surprised by the number of nurses lacking CVD training. "With an average practice caseload having about 10% of registered patients with heart disease, this is sad," she commented. "It should be a core competency of nursing practice and certainly one to include in an induction training programme."

On a positive note, almost 86% of respondents had undertaken some type of basic training in cardiovascular disease, the most popular being inhouse training, with PCT training and reading/web learning not far behind. "I think it is really positive that so many nurses have done some form of training - even if it is fairly basic," commented Linda Goldie, Clinical Director at the Primary Care Training Centre.

Respondents were also asked whether they felt comfortable working with patients with cardiovascular disease. A resounding 72% answered yes - "Having attended numerous study days over the past four years, along with reading journals and inhouse training, I have the confidence to work with patients with cardiovascular conditions," explained a practice nurse from London.

However, 28% answered "no" to this question. "I need more information so that I can offer the correct advice to the patients in my care," replied a community matron from Huddersfield. "The changing roles of the community nurse have come along too fast and many people are now responsible for cardiovascular reviews who are not adequately qualified, but are under pressure to still complete reviews with limited knowledge. I believe this is potentially harmful to the patients in our care."

Marilyn Eveleigh believes that this is a dilemma for many practitioners in a variety of situations: "The NMC code requires all nurses to work within their competency, and each registrant is accountable for their actions." Linda Goldie agrees: "The community matron's comment is so true. They work as autonomous practitioners, generally with prescribing rights and they really should be doing much more formal training which assesses knowledge and skills."

Reference
1. Joint British Societies' (JBS 2) guidelines on the prevention of cardiovascular disease in clinical practice were prepared by the British Cardiac Society, British Hypertension Society, Diabetes UK, HEART UK, Primary Care Cardiovascular Society and The Stroke Association.

You can read the full article online: www.nursinginpractice.com/surveys

The Nursing in Practice-Omron UK cardiovascular disease online survey took place from 12 May to 3 June 2008. A total of 845 primary care nurses completed the survey - 77% practice nurses, 15% nurse practitioners, 5% district nurses, 3% health visitors. In terms of geographical spread, 78.5% came from England, 14% came from Scotland, 3% from Wales, 2% from Northern Ireland and 2.5% from overseas. The survey was sponsored by Omron UK.

Other results:

-- 57% of respondents had a GP lead for cardiovascular disease in their practice and 62% had access to a specialist cardiovascular nurse. "Great news that over half of respondents have access to a specialist CV nurse," commented Linda Goldie. "Could it be that the others just don't know that the nurse is there - most areas do have specialist CV nurses."
-- 91% of respondents had a nurse/HCA-led smoking cessation group available in their practice/PCT (there are now QOF points available for those patients with CHD, stroke or TIA and hypertension, who smoke and have been offered smoking cessation advice or have been referred to a specialist service in the last 15 months); 59% had exercise groups available; and 73% had a weight management group. Linda Goldie believes that the availability of resources for primary care nurses to help patients make lifestyle changes to improve their health is great. "The role of the healthcare assistant is invaluable here - as long as they too have had adequate training," she added.
-- 94% of respondents said that they do routinely offer patients advice, on exercise, reducing salt intake, eating five portions of fruit and vegetables a day, smoking cessation and so on.
-- 17% of respondents routinely recommend alternative or complementary therapies, the main examples being relaxation techniques, aromatherapy, acupuncture, hypnosis, yoga, reflexology and massage. According to Linda Goldie: "Patients with a long-term condition are more prone to depression. Nurses need to be alerted to this and consider the effect that stress and depression has on their overall ability to manage their condition. Alternative and complementary therapies may benefit some patients leading them to be able to self-manage more effectively, improving both quality and quantity of life."
-- Almost 50% of nurses said that BP cuffs are never decontaminated in their practice.

About Omron, Nursing in Practice and Campden Media

Omron Healthcare UK (www.omron-healthcare.com) is aspiring to help people realise a healthy and comfortable life. Today, there is a growing awareness by doctors, governments and the general public of preventive care. Omron Healthcare UK's mission is to make a contribution to prevent and treat lifestyle diseases.

Omron blood pressure monitors offer you true quality, accuracy and reliability. Many of the professional models also have manual and arrhythmia detection functions for ease of use. In addition to the blood pressure range we have the totally portable hand held ECG unit, the HeartScan. This simple device can record up to 30 seconds of ECG data which is suitable for use in surgery and home care environments. It provides a solution to diagnose cardiac patients, such as AF, at an affordable price.

Nursing in Practice (www.nursinginpractice.com) is a bimonthly review journal produced by Campden Publishing that delivers accessible, relevant and informed news, indepth articles and comment on modern nursing practice in primary care. It is part of a family of products and services including events, exhibitions, online content and recruitment. All these products are specifically designed for practice nurses and other primary care specialists working across the UK and aim to promote best practice and thus improve patient care.

nursinginpractice.com is a free online service designed to complement the Nursing in Practice journal. Visitors to the site can get daily news online or delivered direct to their inbox by email each week. In addition to news, there is also a complete archive of all past issues of Nursing in Practice, regular online comment, a weekly quiz and many other features, including video presentations from our latest live events. Nursing in Practice Events (www.nursinginpractice.com/events) is the largest free conference and expo series designed specifically to meet the educational needs of practice nurses and other primary care specialists. Each programme features an impressive collection of speakers delivering highly topical and relevant presentations that contribute to attendees' professional development. These educational conferences are complemented by an exhibition featuring key charities, product suppliers, educational institutes, services for primary care and recruitment specialists. In 2008, Nursing in Practice Events will be visiting:

-- London - Business Design Centre - Tuesday 23 and Wednesday 24 September 2008 -www.nursinginpractice.com/london

-- Birmingham - NEC - Wednesday - 19 November 2008 - www.nursinginpractice.com/birmingham

Campden Publishing is a division of Campden Media (www.campden.com), a specialist business-to-business information provider. The company delivers essential information in two core markets - finance and healthcare. Our brands create high-quality content that is delivered to our audiences via the combined channels of print, online, research, conferences and exhibitions. Campden Media is a global organisation with offices in London, New York and Singapore.