title: The role and scope of practice of nurses working in Canadian heart failure clinics.
abstract: BACKGROUND
  Nurses play an integral role in providing care in heart failure (HF) clinics and disease management programs that lead to improved outcomes for HF patients.
  
  
  OBJECTIVE
  This pilot study explored how closely nurses in Canadian HF clinics follow consensus guideline recommendations and nursing interventions from published studies.
  
  
  METHODS
  A total of 27 nurses from HF clinics across Canada completed a questionnaire about their role and scope of practice.
  
  
  RESULTS
  The majority of nurses covered recommended topic areas for counseling and education with the exceptions of discussing advanced directives, teaching patients to titrate diuretics, and counseling on secondary prevention. Nurses with a postgraduate degree were more likely to independently titrate medications and order echocardiograms. Nurses affiliated with the Canadian Congestive HF Clinic Network were more likely to provide telephone management, titrate medications, and order echocardiograms and other diagnostic tests.
  
  
  CONCLUSIONS
  Patients may not be experiencing the benefits that are reported in the literature for being followed up in a HF clinic because the role and scope of practice of nurses varies from one clinic to another. The role and scope of practice of nurses in HF clinics needs to be standardized.
authors.affiliation: Heart Failure Clinic, Hotel Dieu Hospital, Kingston, Ontario, Canada.
authors.forename: Patti
authors.initials: P
authors.lastname: Staples
authors.forename: Wendy
authors.initials: W
authors.lastname: Earle
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000592:standards; D002170:Canada; D002983:Clinical Competence; D003376:Counseling / Q000592:standards; D004506:Education, Nursing / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards; D024802:Nurse's Role; D009734:Nursing Faculty Practice / Q000592:standards; D010353:Patient Education as Topic / Q000592:standards; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires