The post-infarction nurse practitioner project: A prospective study comparing nurse intervention with conventional care in a non-high-risk myocardial infarction population.
OBJECTIVE
To confirm the feasibility of nurse practitioner interventionin non-high-risk patients with recent myocardial infarction (MI).


METHODS
Observational study.


METHODS
Acute coronary care unit in a teaching hospital.


METHODS
We performed an open-label feasibility study to identify non-high-risk MI patients and evaluate the outcome of a new nurse practitioner intervention programme. The initial pilot phase served to identify the non-high-risk population. In the subsequent confirmation phase, 500 consecutive non-high-risk post-MI patients with preserved LV function without heart failure were included to receive nurse practitioner management. The nurse practitioner intervention started on transfer from the coronary care unit to the cardiology ward and continued thereafter for up to 30 days.


METHODS
Time to first event analysis of death from all causes or repeat myocardial infarction.


RESULTS
500 Patients without signs of heart failure or depressed LV function were identified as nonhigh- risk and eligible for inclusion in the nurse practitioner intervention programme. In the implementation phase, none of the patients died and 0.9% developed a repeat myocardial infarction after 30 days of follow-up. Compared with the pilot phase, patients in the implementation phase spent fewer days in hospital (mean 11.1 versus 6.2 days; p<0.001).


CONCLUSIONS
It is feasible to identify non-high-risk post-MI patients, who can be managed adequately by a nurse practitioner. Embedding experienced nurse practitioners within critical care pathways may result in significant decreases in length of hospital stay. (Neth Heart J 2009;17:61-7.Neth Heart J 2009;17:61-7.).
Broers
C J M
CJ
Department of Cardiology, Medical Centre Alkmaar, Alkmaar, the Netherlands.
Sinclair
N
N
van der Ploeg
T J
TJ
Jaarsma
T
T
van Veldhuisen
D J
DJ
Umans
V A W M
VA