title: Effectiveness and Safety of an Independently Run Nurse Practitioner Outpatient Cardioversion Program (2009 to 2014).
abstract: Sustained growth in the arrhythmia population at Stanford Health Care led to an independent nurse practitioner-run outpatient direct current cardioversion (DCCV) program in 2012. DCCVs performed by a medical doctor, a nurse practitioner under supervision, or nurse practitioners from 2009 to 2014 were compared for safety and efficacy. A retrospective review of the electronic medical records system (Epic) was performed on biodemographic data, cardiovascular risk factors, medication history, procedural data, and DCCV outcomes. A total of 869 DCCVs were performed on 557 outpatients. Subjects were largely men with an average age of 65 years; 1/3 were obese; most had atrial fibrillation; and majority of subjects were on warfarin. The success rate of the DCCVs was 93.4% (812 of 869) with no differences among the groups. There were no short-term complications: stroke, myocardial infarction, or death. The length of stay was shortest in the NP group compared to the other groups (p <0.001). In conclusion, the success rate of DCCV in all groups was extremely high, and there were no complications in any of the DCCV groups.
authors: Formerly Stanford University School of Medicine, Stanford, California.
authors: Linda
authors: L
authors: Norton
authors: Stanford Health Care, Stanford, California. Electronic address: atsiperfal@stanfordhealthcare.org.
authors: Angela
authors: A
authors: Tsiperfal
authors: Sutter Health/Palo Alto Medical Foundation, Palo Alto, California.
authors: Kelly
authors: K
authors: Cook
authors: Stanford Health Care, Stanford, California.
authors: Ani
authors: A
authors: Bagdasarian
authors: Formerly Stanford University School of Medicine, Stanford, California.
authors: John
authors: J
authors: Varady
authors: Oakland University William Beaumont School of Medicine, Rochester, Michigan.
authors: Manali
authors: M
authors: Shah Sheth
authors: Stanford University School of Medicine, Stanford, California.
authors: Paul
authors: P
authors: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods* / Q000458:organization & administration; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D009202:Cardiomyopathies / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D009765:Obesity / Q000453:epidemiology; D061214:Patient Safety; D010820:Physicians; D057184:Practice Patterns, Nurses'; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin