title: The development of a new cardiac rehabilitation needs assessment tool (CRNAT) for individualised secondary prevention.
abstract: BACKGROUND
  Cardiac rehabilitation and secondary prevention are evidence-based strategies to reduce the risk of recurrent cardiac events but are underutilised. New approaches are required to improve uptake.
  
  
  METHODS
  A new cardiac rehabilitation needs assessment tool (CRNAT), for use by cardiology ward nurses, was developed and refined in collaboration with stakeholders through action research. The tool documented patients' risk factors, initiated a discussion about secondary prevention and linked patients to post-discharge follow-up. The initial version of the tool was developed through consultation with cardiac rehabilitation specialist staff (n=3), reviewed by ward nurses (n=4) and general practitioners (GP) (n=8), and piloted in patients (n=8). Review was undertaken at six months post implementation through patient (n=66) and GP (n=10) surveys, with additional patient feedback through focus groups (n=8 patients) and phone interviews (n=14). At 12 months, ward nurses (n=21) were surveyed.
  
  
  RESULTS
  The CRNAT was well regarded by patients and GPs and stakeholder feedback resulted in only minor changes to the tool's content. Feedback from ward nurses led to important changes to the process of administering the tool to streamline its use in an inpatient setting.
  
  
  CONCLUSIONS
  Feedback from end users is important when developing a new clinical tool to ensure it meets their requirements.
authors: National Heart Foundation, Subiaco, Western Australia, 6008; Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, 6000.
authors: Julie
authors: J
authors: Smith
authors: Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001; Clinical Services, Royal Perth Hospital, Perth, Western Australia, 6000; Bentley Armadale Medicare Local, Bentley, Western Australia, 6102.
authors: Jacquie
authors: J
authors: Garton-Smith
authors: Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001; Cardiovascular Research Group, School of Population Health, The University of Western Australia, Nedlands, 6009.
authors: Tom
authors: T
authors: Briffa
authors: Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001; Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, Western Australia, 6000; School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, 6102. Electronic address: A.Maiorana@curtin.edu.au.
authors: Andrew
authors: A
authors: Maiorana
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000517:prevention & control* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D057285:Precision Medicine / Q000379:methods*; D013673:Technology Assessment, Biomedical
keywords: Acute coronary syndrome; Cardiac rehabilitation; Risk factors; Secondary prevention; Service redesign