Outcomes of nurse practitioner‐led care in patients with cardiovascular disease: A systematic review and meta‐analysis. (24th October 2019) - Smigorowsky, Marcie J.
Abstract: Aim: To assess randomized controlled trials evaluating the impact of nurse practitioner‐led cardiovascular care. Background: Systematic review of nurse practitioner–led care in patients with cardiovascular disease has not been completed. Design: Systematic review and meta‐analysis. Data sources: The Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, Web of Science, Scopus and ProQuest were systematically searched for studies published between January 2007 ‐ June 2017. Review Methods: Cochrane methodology was used for risk of bias, data extraction and meta‐analysis. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation approach. Results: Out of 605 articles, five articles met the inclusion criteria. There was no statistical difference between nurse practitioner‐led care and usual care for 30‐day readmissions, health‐related quality of life and length of stay. A 12% reduction in Framingham risk score was identified. Conclusion: There are a few randomized control trials assessing nurse practitioner‐led cardiovascular care. Impact: Low to moderate quality evidence was identified with no statistically significant associated outcomes of care. Nurse practitioner roles need to be supported to conduct and publish high‐quality research. Abstract : 目的: 在于评估随机对照试验, 从而评估执业护士主导型护理心血管护理的影响。 背景: 尚未完成对心血管疾病患者进行执业护士主导型护理的系统综述。 设计: 系统综述和荟萃分析。 资料来源: 在 Cochrane Central Register of Controlled Trials (CENTRAL)、Medline、Embase、CINAHL、Web of Science、Scopus和ProQuest上系统地搜索了2007年1月至2017年6月间发表的研究。 综述方法: Cochrane方法学用于偏倚风险、数据提取和荟萃分析。证据质量的评估采用了GRADE(Grading of Recommendations Assessment, Development and Evaluation)法。 结果: 在605篇文章中, 有5篇符合纳入标准。执业护士主导型护理和30天再度入院的常规护理、健康相关生活质量和住院天数之间没有统计学差异。确定Framingham 风险评分降低了12%。 结论: 有一些随机对照试验评估了执业护士主导型心血管护理。 影响: 确定了低等至中等质量的证据, 没有统计学意义的相关护理结果。需要支持执业护士的角色, 从而开展和发布高质量研究。