Nurses role in cardiovascular risk assessment and communication: Indian nurses perspective

Abstract

Background: Internationally, the implementation of cardiovascular disease (CVD) prevention programs by nurse practitioners is being encouraged. Evidence suggests the effectiveness of nurse-led clinics for the primary and secondary prevention of CVDs. However, in India, nurses are underutilized for this task. The present study was undertaken to check the feasibility of task shifting of CVD risk assessment and management by nurses and have concluded that given appropriate training, nurses can do this task. However, to facilitate the implementation of these tasks by nurses at the larger level, barriers need to be identified and lifted. Hence, the experiences of nurses who participated in the study were assessed. Methodology: Qualitative approach was adopted to explore the experiences of nurses who participated in the study to determine the potential barriers and facilitators to implementing CV risk assessment and management using the World Health Organization/International Society of Hypertension (WHO/ISH) charts as routine practice by nurses. In-depth interviews were conducted with the help of the topic guide. These interviews were transcribed verbatim for analysis. A total of six in-depth interviews were conducted. No new themes emerged after the first four interviews. Results: A total of six nurses participated in the study. All the nurses were female, with the mean age of 38 ± 9.2 years. The analysis resulted in seven key themes which are crucial to the nurses involvement in CVD risk assessment and management. The themes are (1) Use of WHO/ISH charts in routine nursing practice, (2) Lack of contact with patients, (3) Time, (4) Lack of appraisal and Performance-based appraisal, (5) Increasing the scope of task shifting, (6) Infrastructure, (7) Training facilities for nurses, (8) Team member support. Conclusion: The study concludes that despite the challenges and barriers participating nurses expressed their willingness to do the task of CVD risk assessment and management. Appropriate training and continuous feedback from the higher health-care professional is essential for the successful implementation of CVD risk assessment and communication as routine practice by nurses. The availability of adequate workforce and time were the key concerns raised by participating nurses.