Self-management education in patients with cardiovascular disease: a best practice implementation project

Abstract

BACKGROUND Cardiovascular disease is a chronic condition with a significant incidence among Myanmar people. Self-management education is required in patients with cardiovascular disease, to facilitate them in effectively self-managing their chronic condition and achieving optimal well-being and quality of life. This paper reports on a best practice implementation project conducted in 2013, to enhance self-management education in patients admitted with cardiovascular disease at the medical ward of No. (1) Military Hospital, Myanmar. OBJECTIVES The aim of this project was to improve the local clinical practice of self-management education in patients with cardiovascular disease, and to ensure that this practice was performed in accordance with the best available evidence. METHODS The project used the Joanna Briggs Institute’s Practical Application of Clinical Evidence System and Getting Research into Practice audit tool. A baseline audit was conducted followed by an education strategy and follow-up audit. The sample included 16 in-patients and 12 staff nurses. Data collection involved review of patient medical records, observation at the clinical setting and interviews with the patients and nursing staff. RESULTS The post implementation audit showed a 63% increase in compliance with audit criteria one and two, less than 50% in criteria three, four and six, and 50% greater in criteria five, seven and eight. Improvement was seen with all eight criteria in relation to the baseline audit. However, awareness, staff motivation and policy support were all necessary to be further enhanced in order to increase compliance with best practice of self-management education in this project setting. CONCLUSION Despite the known benefits of self-management for cardiovascular disease, we were initially underperforming in this area within our setting. This project presents another example of the power of the audit and feedback tool as a means to promote evidence based practice, and implement evidence into action. Through a process of audit, we were able to achieve a significant increase in our compliance with all criteria regarding self-management in our setting, which will be of substantial benefit to our patients. The education sessions held with staff appeared to be of substantial benefit in improving practice. The challenge will now be to ensure we sustain these changes and improve where required.