Biosimilars vs. originators: A comprehensive guide for nurses on efficacy, safety, and patient care.

Biosimilars can potentially increase patient treatment options, allowing access to expensive biologic medications. As frontline caregivers, nurses are uniquely positioned to educate patients on their safety and effectiveness. This article discusses biosimilars and standard terms, their development process, and strategies for nurses to provide effective patient education about these medications.

Heart failure: An update for nurses.

Heart failure (HF) is a chronic syndrome that requires patients to manage signs and symptoms and adhere to a complex medication regimen. This article discusses updates in HF care related to a universal definition and new therapies, focusing on the four pillars of therapy for HF with reduced ejection fraction.

Nurses' personal perceptions of clinical work adaptation during COVID-19.

Background: The clinical work of nurses across the United States was profoundly impacted by the Coronavirus (COVID-19) pandemic. Nurses in both hospital and outpatient settings had to adapt quickly to the continuously changing healthcare environment.

Objective: To describe nurses' responses to open-ended questions of their clinical work adaption during the COVID-19 pandemic.

Decision Delay Is a Significant Contributor to Prehospital Delay for Stroke Symptoms.

Prehospital delay after stroke symptom onset is a primary barrier to eligibility for reperfusion therapies. Decision delay is an understudied contributor to prehospital delay. We aimed to explore decision delay as a component of prehospital delay.

Perceptions of changes in practice patterns and patient care among heart failure nurses during the COVID-19 pandemic.

Background: The Coronavirus (COVID-19) had a profound impact on the delivery of care in both hospital and outpatient settings across the United States. Patients with heart failure (HF) and healthcare providers had to abruptly adapt.

Objective: To describe how the COVID-19 pandemic affected practice patterns of HF nurses.

Standardized Patient Education for Decompensated Cirrhotic Patients and Impact on Clinician Satisfaction.

The development of ascites in patients with cirrhosis can cause numerous complications including abdominal discomfort, pain, respiratory distress, decreased mobility, diminished quality of life, and contributes to an increased mortality. Symptom self-monitoring that incorporates evidence-based treatments has been effective when used by patients with noncirrhotic chronic diseases. Guided by the theory of Self-Care of Chronic Illness, a self-monitoring guide was adapted from an existing validated tool.

Multimorbidity phenotypes in patients presenting to the emergency department with possible acute coronary syndrome.

Background: Multimorbidity (> 2 conditions) increases the risk of adverse outcomes and challenges health care systems for patients with acute coronary syndrome (ACS). These complications may be partially attributed to ACS clinical care which is driven by single-disease-based practice guidelines; current guidelines do not consider multimorbidity.

Objectives: To identify multimorbidity phenotypes (combinations of conditions) with suspected ACS.

Integrating Palliative Care Into Heart Failure Management.

Background: The World Health Organization defines palliative care as an approach that improves the quality of life of patients and their families through the prevention and relief of suffering by assessment and treatment of physical, psychosocial, and spiritual problems. Any patient with chronic debilitating disease, including heart failure, is a candidate for interdisciplinary palliative care to manage their complex physical and psychosocial needs.

Clinical Relevance: The philosophy of palliative care has evolved to include a vision of holistic care extended to all individuals with serious illness and their families or caregivers that should be integrated throughout the continuum of care, including the acute phase.

mHealth Technology and CVD Risk Reduction.

Purpose Of Review: To review existing mHealth-based interventions and examine their efficacy in reducing cardiovascular disease (CVD) risk factors.

Recent Findings: A total of 50 articles are included in this review. The majority of the mHealth interventions targeted a specific CVD risk factor, while 4 addressed 2 or more CVD risk factors.

Multimorbidity in Patients With Acute Coronary Syndrome Is Associated With Greater Mortality, Higher Readmission Rates, and Increased Length of Stay: A Systematic Review.

Objective: The aims of this systematic review were to determine the magnitude and impact of multimorbidity (≥2 chronic conditions) on mortality, length of stay, and rates of coronary intervention in patients with acute coronary syndrome (ACS) and to compare the prevalence of cardiovascular versus noncardiovascular multimorbidities.

Methods: MEDLINE, PubMed, MedlinePlus, EMBASE, OVID, and CINAHL databases were searched for studies published between 2009 and 2019. Eight original studies enrolling patients with ACS and assessing cardiovascular and noncardiovascular comorbid conditions met the inclusion criteria.

Sex Differences in Prehospital Delay in Patients With Acute Stroke: A Systematic Review.

Background: In 2009, the window from symptom onset to administration of tissue plasminogen activator for acute ischemic stroke was extended from 3 to 4.5 hours. Yet no systematic review has addressed prehospital delay by sex for stroke symptoms since this change.

Navigating Symptom Management in Heart Failure: The Crucial Role of the Critical Care Nurse.

High-acuity, progressive care, and critical care nurses often provide care for patients with heart failure during an exacerbation of acute disease or at the end of life. Identifying and managing heart failure symptoms is complex and requires early recognition and early intervention. Because symptoms of heart failure are not disease specific, patients may not respond to them appropriately, resulting in treatment delays.

The association between symptom onset characteristics and prehospital delay in women and men with acute coronary syndrome.

Background: A decision to delay seeking treatment for symptoms of acute coronary syndrome increases the risk of serious complications, disability, and death.

Aims: The purpose of this study was to determine if there was an association between gradual vs abrupt symptom onset and prehospital delay for patients with acute coronary syndrome and to examine the relationship between activities at symptom onset and gradual vs abrupt symptom onset.

Methods: This was a secondary analysis of a large prospective multi-center study.

The Three Rs for Preventing Heart Failure Readmission: Review, Reassess, and Reeducate.

Despite improvements in heart failure therapies, hospitalization readmission rates remain high. Nationally, increasing attention has been directed toward reducing readmission rates and thus identifying patients with the highest risk for readmission. This article summarizes the evidence related to decreasing readmission for patients with heart failure within 30 days after discharge, focusing on the acute setting.

The Quality of Symptoms in Women and Men Presenting to the Emergency Department With Suspected Acute Coronary Syndrome.

Introduction: More than 5.5 million patients present to emergency departments in the United States annually for potential acute coronary syndrome (ACS); however, diagnosing ACS remains a challenge in emergency departments. Our aim was to describe the quality of symptoms (chest discomfort/description of pain, location/radiation, and overall symptom distress) reported by women and men ruled-in and ruled-out for ACS in emergency departments.

Acute Coronary Syndrome Symptom Clusters: Illustration of Results Using Multiple Statistical Methods.

Researchers have employed various methods to identify symptom clusters in cardiovascular conditions, without identifying rationale. Here, we test clustering techniques and outcomes using a data set from patients with acute coronary syndrome. A total of 474 patients who presented to emergency departments in five United States regions were enrolled.

What's the Risk? Older Women Report Fewer Symptoms for Suspected Acute Coronary Syndrome than Younger Women.

The purpose of the study was to determine whether older (≥65 years) and younger (<65 years) women presenting to the emergency department (ED) with symptoms suggestive of acute coronary syndrome (ACS) varied on risk factors, comorbid conditions, functional status, and symptoms that have implications for emergent cardiac care. Women admitted to five EDs were enrolled. The ACS Symptom Checklist was used to measure symptoms.

Estimated Glomerular Filtration Rate and 6-Minute Walk Distance in African Americans with Mild to Moderate Heart Failure.

Background/aims: The 6-minute walk test is a measure of functional capacity in patients with heart failure (HF) or chronic kidney disease (CKD). The association between estimated glomerular filtration rate (eGFR) and 6-minute walk distance (6MWD) has not been investigated in African-Americans (AA), despite them having a higher incidence of CKD and chronic HF. Thus, our aim was to determine if eGFR was an independent predictor of 6MWD in AA >50 years of age with HF.

Impact of comorbidities by age on symptom presentation for suspected acute coronary syndromes in the emergency department.

Background: It is estimated half of acute coronary syndrome (ACS) patients have one or more associated comorbid conditions.

Aims: Aims were to: 1) examine the prevalence of comorbid conditions in patients presenting to the emergency department with symptoms suggestive of ACS; 2) determine if comorbid conditions influence ACS symptoms; and 3) determine if comorbid conditions predict the likelihood of receiving an ACS diagnosis.

Methods: A total of 1064 patients admitted to five emergency departments were enrolled in this prospective study.

Selecting symptom instruments for cardiovascular populations.

The purpose of this review is to provide a guide for researchers and clinicians in selecting an instrument to measure four commonly occurring symptoms (dyspnea, chest pain, palpitations, and fatigue) in cardiac populations (acute coronary syndrome, heart failure, arrhythmia/atrial fibrillation, and angina, or patients undergoing cardiac interventions). An integrative review of the literature was conducted. A total of 102 studies summarizing information on 36 different instruments are reported in this integrative review.

Symptoms Suggestive of Acute Coronary Syndrome: When Is Sex Important?

Background: Studies have identified sex differences in symptoms of acute coronary syndrome (ACS); however, retrospective designs, abstraction of symptoms from medical records, and variations in assessment forms make it difficult to determine the clinical significance of sex differences.

Objective: The aim of this study is to determine the influence of sex on the occurrence and distress of 13 symptoms for patients presenting to the emergency department for symptoms suggestive of ACS.

Methods: A total of 1064 patients admitted to 5 emergency departments with symptoms triggering a cardiac evaluation were enrolled.