Background: The European Society of Cardiology (ESC) has a comprehensive clinical guideline development programme, relevant for all clinicians. However, implementation of guidelines is not always optimal.
Aim: The aim of this study was to determine nurses' and allied professionals' awareness and barriers regarding clinical guideline implementation.
Methods: A cross-sectional survey was administrated online and in print at EuroHeartCare 2015. A questionnaire was developed which examined awareness and barriers to implementation of ESC guidelines on cardiovascular disease prevention in clinical practice (2012) and ESC guidelines in general.
Results: Of the 298 respondents, 12% reported that the prevention guidelines were used in their practice area. Respondents identified, in order of magnitude, that lack of leadership, workload, time, resources and a perception that they were unable to influence current practice were barriers to the use of the prevention guidelines. When asked to rank barriers to use of any ESC guidelines, time (22%) and leadership (23%) were ranked highest.
Conclusions: Implementation of ESC guidelines by nurses, the majority responders in this survey, is a serious problem, requiring urgent improvement to ensure patients receive optimal evidence based care. Issues of leadership, workload, time and resources are significant barriers to guideline implementation. It is of concern that these professionals perceive both that they have little influence on implementation decisions and lack of leadership regarding guideline implementation. Educational and organisational strategies to improve leadership skills are imperative. These will build self-efficacy and empower nurses and allied professionals to advocate for evidence-based care in the clinical environment.
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http://dx.doi.org/10.1177/1474515117710097 | DOI Listing |
Eur Heart J Case Rep
January 2025
Service de Cardiologie, Hôpital Trousseau, CHU de Tours, Avenue de la République, 37170 Chambray-Les-Tours, France.
Background: Myocardial bridging (MB) is considered a frequent and benign condition. However, some patients may experience symptoms. The recent ESC guidelines on sports participation provide guidance on the management of these symptomatic patients with MB but do not provide guidance in the presence of another cardiac pathology.
View Article and Find Full Text PDFOpen Heart
January 2025
Department of Cardiology, University Hospital Basel, Basel, Switzerland.
Background: The majority of functional ischemia tests in patients with suspected chronic coronary syndromes (CCS) yield normal results. Implementing gatekeepers for patient preselection, such as pretest probability (PTP) and/or coronary artery calcium score (CACS), could reduce the number of normal scan results, radiation exposure and costs. However, the efficacy and safety of these approaches remain unclear.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland.
Cardiac allograft vasculopathy (CAV) is a major prognosis-limiting factor in patients undergoing orthotopic heart transplantation (HT). Due to the diffuse involvement of the coronary tree, CAV lesions are often not amenable to percutaneous coronary intervention (PCI), leaving coronary artery bypass grafting (CABG) and retransplantation as primary revascularization options. : The latest guidelines from the International Society for Heart and Lung Transplantation (ISHLT) recognize CABG as a viable option but with a downgraded strength of recommendation.
View Article and Find Full Text PDFCardiol J
January 2025
Department of Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy.
According to the ESC guidelines, cangrelor may be considered in P2Y12-inhibitor-naïve acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The aim of this review is to summarize available evidence on the optimal maintenance therapy with P2Y12 receptor inhibitor after cangrelor. Transitioning from cangrelor to a thienopyridine, but not ticagrelor, can be associated with a drug-drug interaction (DDI); therefore, a ticagrelor loading dose (LD) can be given any time before, during, or at the end of a cangrelor infusion, while a LD of clopidogrel or prasugrel should be administered at the time the infusion of cangrelor ends or within 30 minutes before the end of infusion in the case of a LD of prasugrel.
View Article and Find Full Text PDFEuroIntervention
January 2025
Department of Cardiac-Thoracic-Vascular Sciences, University of Padua, Padua, Italy.
This clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions was developed in association with the European Society of Cardiology Working Group on Cardiovascular Surgery. It aims to define procedural and contemporary technical requirements that may improve the efficacy and safety of percutaneous coronary intervention (PCI), both in the acute phase and at long-term follow-up, in a high-risk cohort of patients on optimal medical therapy when clinical and anatomical high-risk criteria are present that entail unacceptable surgical risks, precluding the feasibility of coronary artery bypass grafting (CABG). This document pertains to patients with surgical contraindication according to the Heart Team, in whom medical therapy has failed (e.
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