2008 Poster Presentation Winners
A wide range of poster presentation were highlighted at the Preventive Cardiovascular Nurses Association's ninth annual poster session at the annual symposium in Orlando, Florida, April 16 to 18. The purpose of the poster session was to present original research findings and share new and innovative ideas for successful approaches to cardiovascular risk reduction and disease management in the categories of data-based research and clinical patient management. Below are the top 3 winners in each category.
Clinical Patient Management Category
First Place
Tapping Into the Underdiagnosed Condition of Peripheral Arterial Disease Through Comprehensive Vascular Assessments
Kelly A. Galler, MSN, GNP
Background. Approximately 8 to 10 million Americans have peripheral arterial disease (PAD). Three of 4 Americans know little or nothing about PAD, and evaluations for vascular disease are not routinely done in the primary care setting. The ankle brachial index (ABI) is an easy and noninvasive test that can be used to diagnose PAD.
Objective. The goals of this program are to (1) increase awareness in the primary care setting and community, (2) promote prevention through risk factor modification and counseling, and 3) assist with early identification of vascular disease in the community.
Methods. A resource booklet called Guidelines for Vascular Disease was developed and given primary care physicians in conjunction with a lecture series on vascular disease. Through avenues such as TV, newspaper articles, direct mailing, and educational pamphlets, the community has been made aware of the symptoms and risk factors of vascular disease and has been encouraged to take advantage of a free comprehensive vascular assessment. Key components of the assessment include palpation and auscultation of pulses, abdominal aorta palpation, lower extremity evaluation for signs of decreased circulation, and ABI.
Results. Primary care providers are referring patients into the program, and individuals are scheduling themselves for vascular assessments. A total of 232 patients have had a vascular assessment between August 2007 and January 2008. Each person has received risk factor modification counseling specific to his/her individual needs. Twelve percent of these patients, aged 28 to 92 years, have been diagnosed with PAD through resting ABI assessment.
Conclusion. Educational materials have been proven to be an effective tool to increase awareness and promote vascular assessments in the community. An overwhelming response of appreciation for risk factor counseling and early identification of PAD has been expressed from the community.
Second Place
A Systemwide Model For Improving ST Elevation Myocardial Infarction Care
Melanie B. Johnson, RN
Cynthia P. Smith, MSN, RN
Paul T. Frantz, MD
Third Place
Beyond Awareness: Helping Women Personalize Their Risk for Cardiovascular Disease
Pam Kozu, RN, MN
Glenn Bean, MS, FAACVPR
Data-Based Research Category
First Place
Dietary Energy Density: A Potential Mediator of Disease Risk in Overweight Adults
Daurice A. Grossniklaus, RN, MS, ME
Margaret F. Pedersen, RD, LD
Sandra B. Dunbar, RN, DSN, FAAN
Background. Abdominal obesity is associated with insulin resistance and cardiometabolic disease. In 2003 to 2004, more than 50% of adults had abdominal obesity. A conceptual model accounting for environmental demands predisposing individuals to psychological distress is proposed. Depending on coping behaviors and resources, psychological distress may alter biobehavioral responses contributing to abdominal obesity. Increased dietary energy density (DED) represents a risk factor for abdominal fat deposition because of excess intake of energy and total and saturated fats. Dietary energy density is a potential biobehavioral mediator between psychological distress and abdominal obesity.
Objectives. This study examines associations among psychological factors, biobehavioral response, and disease risk in overweight adults and compares DED values to a national sample.
Methods. Adults aged 18 to 65 years without coronary artery disease were recruited for this correlational study. Inclusion criteria were a body mass index of more than or equal to 25.0 kg/m2 and sedentary lifestyle. Exclusion criteria were being pregnant, breastfeeding, having diabetes, or engaging in weight loss activities. The variables and measures are demographic data, depressive symptoms (Beck Depression Inventory II [BDI-II]), perceived stress (Perceived Stress Scale [PSS]), DED (weighed 3-day food record to calculate kilocalories per gram of food and beverages), and abdominal obesity (waist circumference [WC] using National Health and Nutrition Examination Survey procedures). Data analyses used were descriptive statistics; Pearson correlation to test relationships between PSS, BDI-II, and WC; and one sample t tests to compare study DED with national sample.
Summary. The sample (N = 32) was composed of 78% women and 58% African American, with age ranging from 20 to 57 years, mean BMI of 32.39 kg/m2, and mean WC of 101.23 cm. Moderate correlations between BDI-II and PSS (r = 0.601, P < .0001) and between PSS and WC (r = 0.360, P = .043) were found. Food and beverage DED was significantly less than that of the national sample (t = 2.805, P = .009).
Conclusions. As perceived stress increased, depressive symptoms and waist circumference increased. Food and beverage DED was lower than that of the national sample because of the inclusion of water in DED calculations. Methodological challenges are subject underreporting and inclusion/exclusion of beverages in calculating DED.
Second Place
Self-identified Educational Needs of Female Ambulatory Cardiology Patients as Compared to Perceived Educational Needs of the Healthcare Provider Using a Card Sort Technique
Cherie Parks, BSN, RN-BC
Cherie Chaney, BSN, RN
Elizabeth Hooper, BSN
Mary Lou Perry, MS, RD, CDE
Melly Turner, BSN, RN-BC
Third Place
Prevention in Primary Care: Using Computer-Generated Guidelines at Clinic Visits to Improve Family Practice
Reni Courtney, FNP, PhD
Preventive Cardiovascular Nurses Association Supports Geriatric Cardiology Summit
As cardiovascular nurses already know, prevention can improve outcomes for older adults, and exercise plays a huge role in that prevention prescription. To help educate healthcare professionals on issues critical to our aging population, the Summit on Maximizing Functional Capacity in Older Cardiovascular Patients was held in June in Washington, DC.
This important meeting was sponsored by the Society of Geriatric Cardiology, the Preventive Cardiovascular Nurses Association, and the American Association of Cardiovascular and Pulmonary Rehabilitation.
Selected topics included the following: Strains to the American healthcare systems as it prepares for anticipated demands; The interrelationship between aging and cardiovascular pathophysiology; Changes in functional capacity with aging in healthy adults: effects of aerobic exercise interventions; CAD in the elderly: implications of the COURAGE trial on CAD management in older adults; Maximizing functional capacity in older patients with heart failure; and Implications of functional decline and pertinent clinical strategies.
Clinical experts from across the country shared their expertise on these topics and many more. This summit provided important clinical information to clinicians caring for adult patients with cardiac and other vascular diseases. For more information about geriatric care, visit the Society of Geriatric Cardiology Web site at http://www.sgcard.org.
The Virtual Lipid Preceptorship
Baylor College of Medicine, the Preventive Cardiovascular Nurses Association, and the National Lipid Association have developed an exciting new online self-study CME activity focusing on improving healthcare delivery to patients at risk for coronary heart disease. This new program is called "The Virtual Lipid Preceptorship" (VLP) and is available at http://lipidsonline.org. The VLP is a series of streaming media and slide set presentations designed to introduce you to the principles and applications of continuous quality improvement, encourage you to participate in assessing your practice's current performance in patient care, help you create and implement plans to improve that performance, and measure the impact of these improvements on both practice performance and patient healthcare indicators. This program uses your own clinical practice to conduct the VLP exercises to assist you in learning that through changing the clinic's processes, you can improve performance and patient outcomes.
The VLP is divided into 3 modules with audio and slides to lead you through the information and exercises. These modules include the following:
1. Module 1: An introduction to lipid management and continuous improvement
2. Module 2: Applying continuous quality improvement principles to lipid management
3. Module 3: Addressing common barriers to effective lipid management
The VLP also contains an extensive library of free downloadable materials and references that can facilitate your education and the implementation of improvement plans in your clinic. The materials can be accessed and downloaded anytime for use in your practice. CME credit will be awarded for participation in the activities and when you use the lipid practice audit tool. Proof of participation and an online posttest are required before a credit certificate is issued. For more information and to download materials, visit http://www.lipidsonline.org/vlp/.
NEW: Scope and Standards of Practice for Cardiovascular Nursing
Nurses share a legacy of providing care for patients with cardiovascular needs across a broad spectrum of healthcare environments. Cardiovascular nursing subspecialties range from acute care to prevention and from electrophysiology to heart failure and rehabilitation, to name a few. Nurses practicing in these specialties care for patients across the lifespan. It is a testament to the creativity and perseverance of more than 15 recognized cardiovascular specialty nurse organizations that a new version of Cardiovascular Nursing: Scope and Standards of Practice has been published.
This new document, which has been in development and review for 3 years, describes the advanced cardiovascular knowledge base and scope of practice for cardiovascular nurses. The Preventive Cardiovascular Nurses Association is proud to have been a member of the American College of Cardiology/American Nurses Association Writing Group and applauds the efforts of these nurse pioneers. A copy of this important document can be obtained by contacting the American Nurses Association at http://www.nursingworld.org/booksm.
New Tools to Help Patients Modify Their Health Risks
There are 2 new tools available to cardiovascular nurses. Both tools, the "Diabetes PhD" offered through the American Diabetes Association, and the "General Cardiovascular Risk Profile for Use in Primary Care," are easy to use with patients.
The Diabetes PhD is found at http://www.diabetes.org/diabetesphd/default.jsp?WTLPromo=Home_flash_030408PHD. This tool asks a provider or patient to create a personal health record by entering height, weight, cholesterol levels, blood pressure readings, last dilated eye examination, current medications, A1c number, and other risk factors into a confidential online tool. The tool then displays current risk for diabetes, heart attack, stroke, kidney failure, and eye complications. By changing certain variables in the profile (ie, smoking cessation, weight loss, or angiotensin-converting enzyme inhibitors intake), patients can graphically see how making these changes would affect their future health.
The second tool was developed by D'Agostino et al in an article appearing in the February 12, 2008, issue of Circulation entitled "General Cardiovascular Risk Profile for Use in Primary Care." The tools in the article are easier to use than other point-assigning algorithms. A patient's risk is calculated using age, HDL, blood pressure, smoking status, and diabetes status. The tool also allows a provider to assign a heart/vascular age. This could be an important patient motivator to bring heart age closer to chronological age.
Heart Failure Nurses Meet in Boston
"Raising the Bar in Heart Failure Care" was the theme of the American Association of Heart Failure Nurses fourth annual meeting held in June in Boston, Massachusetts. A popular half-day premeeting outlined evidenced-based essentials of heart failure disease management programs. Sessions led by national nurse experts included talks on formulating business plans, developing clinical protocols and educational tools, measuring quality and outcomes, and examining financial and marketing issues.
The main program was organized around 3 education tracks: (1) cornerstones of heart failure, which covered basic pathophysiology and patient assessment and treatment; (2) advanced aspects of heart failure for advanced practice nurses; and (3) global aspects of heart failure, which included sessions on genetics, smoking cessation, and basic science/nursing research.
With the growing number of patients diagnosed annually with heart failure and the challenging self-care expectations confronting these patients, all cardiovascular nurses need to keep abreast of these state-of-the-art care strategies.
Section Description
The Journal of Cardiovascular Nursing is the official journal of the Preventive Cardiovascular Nurses Association. PCNA is the leading nursing organization dedicated to preventing cardiovascular disease through assessing risk, facilitating lifestyle changes, and guiding individuals to achieve treatment goals.