The role of community-based nursing interventions in improving outcomes for individuals with cardiovascular disease: A systematic review

• Published in: International journal of nursing studies 2019-12, Vol.100, p.103415-103415, Article 103415
• Main Authors: Han, Emeline, Quek, Rina Yu Chin, Tan, See Mieng, Singh, Shweta R, Shiraz, Farah, Gea-Sánchez, Montserrat, Legido-Quigley, Helena
• Format: Article
• Language: English
• Subjects: Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - nursing; Clinical outcomes; Community health nursing; Community Health Nursing - organization & administration; Community nursing; Community-based programs; Cost analysis; Disease management; Emergency services; Functional status; Health care expenditures; Health services utilization; Home health nursing; Humans; Interdisciplinary aspects; Intervention; Nurses; Nursing; Nursing care; Parent participation; Quality of care; Quality of life; Readmission; Risk assessment; Self care; Systematic review; Treatment Outcome
• ISSN: 0020-7489; 1873-491X
• DOI: 10.1016/j.ijnurstu.2019.103415

To examine the role of community-based nursing interventions in improving outcomes for community-dwelling individuals with cardiovascular disease. A systematic review and narrative synthesis. Seven electronic databases (MEDLINE, CINAHL, Global Health, LILACS, Africa-Wide Information, IMEMR and WPRIM) were searched from inception to 16 March 2018 without language restrictions. We included studies evaluating the outcomes of interventions led by, or primarily delivered by, nurses for individuals with cardiovascular disease in community settings. Study selection, data extraction and risk of bias assessments were performed by at least two independent reviewers. Twenty-eight studies met the inclusion criteria and were included in this review. Community-based nursing interventions improved outcomes in four key areas: (1) self-care, (2) health, (3) healthcare utilisation, and (4) quality of care. Significant improvements were reported in patients’ knowledge and ability to self-manage, severity of disease, functional status, quality of life, risk of death, hospital readmission days, emergency department visits, healthcare costs and satisfaction with care. Facilitators to intervention effectiveness included the use of an individualised approach, multidisciplinary approach, specially trained nurses, family involvement and the home setting. Conversely, barriers to intervention success included limitations in nurses’ time and skills, ineffective interdisciplinary collaboration and insufficient intervention intensity. The overall evidence is positive regarding the role of community-based nursing interventions in improving outcomes for individuals with cardiovascular disease. However, this review highlights the need for more robust research establishing definitive relationships between different types of interventions and outcomes as well as evaluating the cost-effectiveness of these interventions to aid the development of sustainable policy solutions.