Epworth Collection:

Cardiac rehabilitation ambassador: A new model to enhance patient participation.

Fri, 01 Aug 2025 00:00:00 GMT

Title: Cardiac rehabilitation ambassador: A new model to enhance patient participation. Epworth Authors: Kevill, Jo; Hooper, Suzie; Cacavas, Glynis Abstract: Introduction: Participation in outpatient Cardiac Rehabilitation (CR) is considered an integral part of secondary treatment of heart disease. Despite being considered standard care, participation remains low internationally. Encouraging patients to enrol in Cardiac Rehabilitation during their hospital stay is linked to higher participation. This study was conducted at a hospital that provides acute cardiac and rehabilitation services in Australia. Aim: As a leading provider of cardiac services, we identified that potentially increasing acute cardiac nurses’ knowledge of the benefits of CR through an immersion experience would improve their capacity to actively promote participation in CR programs with patients during their acute hospital stay.

Establishing a nurse cardiac rehabilitation ambassador program to increase promotion and uptake of cardiac rehabilitation following an acute care admission.

Fri, 01 Aug 2025 00:00:00 GMT

Title: Establishing a nurse cardiac rehabilitation ambassador program to increase promotion and uptake of cardiac rehabilitation following an acute care admission. Epworth Authors: Kevill, Jo; Hooper, Suzie; Cacavas, Glynis Abstract: Introduction: Participation in outpatient Cardiac Rehabilitation (CR) is considered an integral part of secondary treatment of heart disease. Despite being considered standard care, participation remains low internationally. Encouraging patients to enrol in CR during their hospital stay is linked to higher participation. [1] This study was conducted at a hospital that provides acute cardiac and rehabilitation services in Australia. Purpose: As a provider of cardiac care, we identified that increasing nurses’ knowledge of the of CR would improve their capacity to promote CR during patient’s hospital stay. Methods: Utilising a quality improvement methodology, the Cardiac Ambassador Initiative was developed with key stakeholders working on cardiac units in 2022. The program consisted of an immersion experience for cardiac nurses to shadow CR nurses working in a specialist rehabilitation centre providing best practice CR for patients with a variety of cardiac conditions. To evaluate the impact of the program, cross-sectional surveys and individual interviews were conducted with participants and Nurse-Unit-Managers (NUMs). Key outcomes included: ambassadors’ knowledge and confidence to promote CR participation to their patients on the wards and NUM's perceptions of the impact of the program. Results: The program was run over two years. The NUMs and CR-coordinator selected a total of 13 nurses to participate. In 2022 4 participants attended a total of 5 days each. Following evaluation, the program was modified to 3 days for participants in 2023, which enabled 9 participants to attend. All participants described not fully understanding the nature of CR and its impact on patients until they attended a program. Prior to attendance, 100% of participants considered it was important or somewhat important for patients to attend CR. Following attendance 100% of participants consider it essential or important for patients to attend. They also reported feeling more confident to discuss CR with patients and colleagues and encourage patient participation following the immersion experience. Pre-attendance 100% of participants felt either not at all confident or somewhat confident to discuss CR with their patients and this improved post program with 100% feeling very confident. 100% of participants also indicated that their confidence and skill in discussing CR with patients greatly improved and recommended that others should participate in the CR Ambassador program. Nurse Unit Managers reported that the CR Ambassadors were a valuable resource for both staff and patients on the cardiac unit and that they had identified a need to review the accessibility of CR information and referral documentation available on their wards. Conclusion: The immersion experience represents a feasible and sustainable approach to establishing CR ambassadors on acute cardiac wards with the skills needed to promote CR participation to colleagues and patients.

Use of wearable devices to monitor post-operative activity following cardiac surgery: A systematic scoping review.

Tue, 01 Oct 2024 00:00:00 GMT

Title: Use of wearable devices to monitor post-operative activity following cardiac surgery: A systematic scoping review. Epworth Authors: Edney, Jessica; McDonall, Jo; Hutchinson, Anastasia Abstract: Aims: There is an emerging trend of using wearable digital technology to monitor patient activity levels in acute care contexts. However, the overall extent and quality of evidence for their use in acute cardiac surgery care are unclear. The purpose of this systematic scoping review was to evaluate current literature regarding the use of wearable activity trackers/accelerometers to monitor patient activity levels in the first 30 days following cardiac surgery. Method and results: A systematic scoping review was conducted. A search of CINAHL and MEDLINE Complete databases identified all peer reviewed research evidence published in English between 2010 and 2023. Studies evaluating the use of wearable technology in adults who had undergone coronary artery bypass graft surgery and valve replacement were included. Study data were summarized thematically. A total of 853 citations were identified. Once duplicates were removed, 816 studies were screened by title and abstract, 54 full-text studies were assessed for eligibility, and 11 studies were included. Accelerometers were able to capture changing exercise and physical activity levels over an acute care admission. Device use was acceptable to clinicians and patients. Low activity levels in the early post-operative period were associated with longer length of stay and higher 30-day readmissions. Conclusion: Wearable devices are acceptable and feasible to use in acute care. The use of wearable activity trackers by acute cardiac patients may increase patient participation in exercise and identify more sedentary patients who are a greater risk of increased length of stay and hospital readmission. Keywords: Cardiac surgery; Cardiac–thoracic nursing; Exercise participation; Exercise rehabilitation; Patent participation; Post-operative recovery; Wearable activity trackers.

Clinical outcomes associated with balloon aortic valvuloplasty in the contemporary era.

Mon, 01 Jan 2024 00:00:00 GMT

Title: Clinical outcomes associated with balloon aortic valvuloplasty in the contemporary era. Epworth Authors: Saleemi, Saadat Ali; Noaman, Samer; Brookes, John; Dick, Ronald Abstract: Background: Severe aortic stenosis is the most common acquired valvular disorder. Balloon aortic valvuloplasty (BAV) is considered for patients who are not suitable for surgical aortic valve replacement (SAVR) and transcatheter aortic valve insertion (TAVI). The American Heart Association and European Society of Cardiology recommend BAV as a bridging procedure for SAVR and TAVI due to the significant morbidity and mortality associated with it. We aim to investigate the morbidity and mortality associated with BAV only, BAV bridged to TAVI and TAVI-only patients over 3 years in Epworth Richmond, a tertiary hospital in Victoria, Australia. Methods: We divided patients into three groups including BAV only, BAV bridged to TAVI and TAVI only and assessed the baseline demographics, procedural complications, and mortality between the groups. Results: Of 438 patients, 26 patients underwent BAV only, 36 patients bridged to TAVI post-BAV and 376 patients underwent TAVI directly. All patients had significant reductions in their mean AV pressure gradient (p<0.01). There was no significant difference in periprocedural morbidity and mortality between the groups. At 6-month follow-up, the mortality in patients undergoing only BAV was 31%, compared with 8.3% in BAV bridged to TAVI and 1.9% in TAVI-only group (p<0.01). The 12-month follow-up demonstrated a similar pattern; 42.3% vs 13.9% vs 4.5% (p<0.01). Conclusions: This study suggests no significant difference in inpatient and periprocedural morbidity and mortality between the three groups but a significant mortality benefit at 6-month and 12-month post valve insertion, either directly or post BAV.