Cardiovascular risk assessment: audit findings from a nurse clinic--a quality improvement initiative.
BACKGROUND
Evidence has shown the effectiveness of risk factor management in reducing mortality and morbidity from cardiovascular disease (CVD). An audit of a nurse CVD risk assessment programme undertaken between November 2005 and December 2008 in a Northland general practice.


METHODS
A retrospective audit of CVD risk assessment with data for the first entry of 621 patients collected exclusively from PREDICT-CVDTM, along with subsequent data collected from 320 of these patients who had a subsequent assessment recorded at an interval ranging from six months to three years (18 month average).


RESULTS
Of the eligible population (71%) with an initial CVD risk assessment, 430 (69.2%) had afive-year absolute risk less than 15%, with 84 (13.5%) having a risk greater than 15% and having not had a cardiovascular event. Of the patients with a follow-up CVD risk assessment, 34 showed improvement. Medication prescribing for patients with absolute CVD risk greater than 15% increased from 71% to 86% for anti-platelet medication and for lipid lowering medication from 65% to 72% in the audit period.


METHODS
The recently available 'heart health' trajectory tool will help patients become more aware of risks that are modifiable, together with community support to engage more patients in the nurse CVD prevention programme. Further medication audits to monitor prescribing trends.


CONCLUSIONS
Patients who showed an improvement in CVD risk had an improvement in one or more modifiable risk factors and became actively involved in making changes to their health.
Waldron
Sarah
S
School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Horsburgh
Margaret
M
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015897:Comorbidity; D004032:Diet; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D009043:Motor Activity; D009520:New Zealand / Q000453:epidemiology; D009731:Nursing Audit / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011785:Quality Assurance, Health Care / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods
D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors