RT Journal Article
T1 Effectiveness of the Advanced Practice Nursing interventions in the patient with heart failure: A systematic review
A1 Ordóñez Piedra, Javier
A1 Ponce Blandón, José Antonio
A1 Robles Romero, José Miguel
A1 Gómez Salgado, Juan
AB Rationale and Aim: Advanced Practice Nurse (APN) is a specialist who has acquiredclinical skills to make complex decisions for a better professional practice. In theUnited States, this figure has been developed in different ways, but in some Europeancountries, it is not yet fully developed, although it may imply a significant advance interms of continuity and quality of care in patients with chronic or multiple pathologies,including cardiac ones and, more specifically, heart failure (HF). The follow- upof HF patients in many countries has focused on the medical management of theprocess, neglecting all the other comprehensive health aspects that contribute todecompensation of HF, worsening quality indicators or patient satisfaction, and thereare not updated reviews to clarify the relevance of APN in HF, comparing the resultsof APN interventions with doctors clinical practice, since the complexity of care thatHF patients need makes it difficult to control the disease through regular treatment.For this reason, this systematic review was proposed in order to update the availableknowledge on the effectiveness of APN interventions in HF patients, analysing fourPICO questions (Patients, Interventions, Comparison and Outcomes): whether APNimplies a reduction in the number of hospital readmissions, if it reduces mortality, if ithas a positive cost- benefit relationship and if it implies any improvement in the qualityof life of HF patients.Design and Methods: A systematic review was performed based on the PRISMAstatement, searching at four databases: PubMed, CINAHL, Scopus and Cuiden.Articles were selected based on the following criteria: English/Spanish language,up to 6 years since publication, and original quantitative studies of experimental,quasi- experimental or observational character. Papers were excluded if they do notcomply with CONSORT or STROBE checklists, and if they had not been published injournals indexed in JCR and/or SJR. For the analysis, two separate researchers usedthe Cochrane Handbook form for systematic reviews of intervention, collecting authorshipvariables, study methods, risks of bias, intervention and comparison groups,results obtained, PICO question or questions answered, and the main conclusions.Results: A total of 43,754 patients participated in the 11 included studies for thedevelopment of this review, mostly from United States and non- European countries,with a clearly visible lack of European publications. Regarding the results related tofirst PICO question, researches reviewed proved that APN implied a reduction in thenumber of hospital readmissions in patients with heart failure (up to 33%). Regardingthe second question, mortality was always lower in groups assisted by APN versus incontrol groups (up to 7.8% vs. 17.7%). Regarding the third question, APN was costeffectivein this type of patient as the cost reduction was eventually calculated in1.9 million euros. Regarding the last question, quality of life of patients who havebeen cared for by an APN had notoriously improved, although one of the papersconcluded that no significant differences were found. All the questions addressed obtaineda positive answer; therefore, APN is a practice that reduced hospital readmissionsand mortality in HF patients. The cost- effectiveness is much better with APNthan with usual care, and although the quality of life of HF patients seems to improvewith APN, more studies are needed to support this focused on this.
PB Wiley
SN 2054-1058
YR 2021
FD 2021-03
LK http://hdl.handle.net/10272/19579
UL http://hdl.handle.net/10272/19579
LA eng
NO Ordóñez Piedra, J., Ponce Blandón, J. A., Robles Romero, J. M. ... Gómez Salgado, J. (2021). Effectiveness of the Advanced Practice Nursing interventions in the patient with heart failure: A systematic review. Nursing Open. DOI: https://doi.org/10.1002/nop2.847
DS Repositorio Institucional de la Universidad de Huelva
RD 31 may 2026