In brief
This scoping review by Ruan et al. , published in 2023, summarizes eighteen studies on nurse-coordinated home-based cardiac rehabilitation for heart failure patients.
What this article is about
Quick Answer
This scoping review by Ruan et al., published in 2023, summarizes eighteen studies on nurse-coordinated home-based cardiac rehabilitation for heart failure patients. It found that nurses primarily assess patients, plan and guide rehab programs at home, and provide follow-up. The reviewed studies reported positive outcomes regarding patient safety, feasibility, and efficacy of these nurse-led programs. The authors conclude that such programs are beneficial but also highlight future research needs in exploring optimal evaluation criteria and program design.
Student takeaways
Key Takeaways
- Nurses primarily focus on patient assessment, planning, guiding, and follow-up in home-based cardiac rehab.
- Studies report positive outcomes regarding patient safety from nurse-coordinated programs.
- The feasibility of these nurse-led home-based rehabilitation programs is supported by the reviewed studies.
- Efficacy of nurse-coordinated home-based cardiac rehabilitation for heart failure patients was reported positively.
- Home-based cardiac rehabilitation coordinated by nurses is identified as beneficial to patients with heart failure.
Student summary
Why This Research Matters
This scoping review, published in the International Journal of Nursing Sciences and led by researchers including Tiantian Ruan, Mengqi Xu, Lingyan Zhu, and Yuan Ding, explores nurse-coordinated home-based cardiac rehabilitation for patients with heart failure. The study aimed to summarize existing research on this topic using Arksey and O'Malley's scoping review framework. A systematic search across eight databases (including PubMed, Embase, Web of Science, EBSCO, SinoMed, CNKI, Wanfang Database, and CSTJ) was conducted from inception up to April 30, 2023.
The key findings indicate that nurses primarily focus on patient assessment, planning and guiding home-based cardiac rehabilitation programs, and providing follow-up care. The studies included in the review reported positive outcomes related to patient safety, feasibility of these nurse-coordinated programs, and their overall efficacy for heart failure patients. These findings suggest that such programs are beneficial.
The authors conclude that home-based cardiac rehabilitation coordinated by nurses is advantageous for patients with heart failure. They also highlight future research directions: exploring the full potential of nurses in this context, determining optimal evaluation criteria for these programs, and developing safe, effective, and economical rehabilitation plans tailored to patient needs. This review provides valuable insights into how nursing can support heart failure management outside traditional clinical settings.
Source abstract
Study Overview
Objectives: This study aimed to review and summarize the studies of nurse-coordinated home-based cardiac rehabilitation for patients with heart failure. Methods: The review was performed using Arksey and O’Malley’s scoping review framework. A systematic search was conducted across eight databases, including PubMed, Embase, Web of Science, EBSCO, China Biomedical Literature Service System (SinoMed), China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Science and Technology Journals (CSTJ) Database, and Chinese Clinical Trial Registry, from inception to 30 April 2023. Articles relevant to the nurse-coordinated home-based cardiac rehabilitation for patients with heart failure were included. Results: Eighteen studies were included in this review. These studies showed that nurses primarily focused on patient assessment, home-based cardiac rehabilitation planning and guidance, and follow-up. The studies also reported positive outcomes in patient safety, feasibility, and efficacy of the programs coordinated by nurses. Conclusions: Home-based cardiac rehabilitation coordinated by nurses is beneficial to patients with heart failure. Future research will explore the potential of nurses in home-based cardiac rehabilitation for patients with heart failure, determine optimal evaluation criteria, and formulate safe, effective, and economical rehabilitation programs suitable for the patients.
Evidence appraisal
Main Findings
- Nurses primarily focus on patient assessment, planning, guiding, and follow-up in home-based cardiac rehab.
- Studies report positive outcomes regarding patient safety from nurse-coordinated programs.
- The feasibility of these nurse-led home-based rehabilitation programs is supported by the reviewed studies.
- Efficacy of nurse-coordinated home-based cardiac rehabilitation for heart failure patients was reported positively.
- Home-based cardiac rehabilitation coordinated by nurses is identified as beneficial to patients with heart failure.
Practice transfer
Clinical Relevance
- Nurse-led home-based cardiac rehab can improve safety and outcomes for HF patients, reducing hospital readmissions.
- This model offers a feasible alternative or supplement to traditional inpatient/cardiac rehab programs.
- Nurses are well-positioned to deliver effective home-based rehabilitation, enhancing patient care accessibility.
- Implementing such programs could lead to more cost-effective management of heart failure by preventing complications at home.
- Further development and standardization of nurse-coordinated home-based cardiac rehab protocols is recommended for broader clinical application.
Faculty notes
Educational Relevance
This scoping review by Ruan et al., published in the International Journal of Nursing Sciences (DOI: 10.1016/j.ijnss.2023.09.022), systematically examines nurse-coordinated home-based cardiac rehabilitation for heart failure patients using Arksey and O'Malley's framework. The authors conducted a comprehensive search across eight databases, including PubMed, Embase, Web of Science, EBSCO, SinoMed, CNKI, Wanfang Database, and CSTJ, up to April 30, 2023.
The review identified eighteen studies that collectively demonstrate nurses' central role in this model. Key activities include patient assessment, development and guidance of home-based rehabilitation plans, and ongoing follow-up. The findings consistently report positive outcomes concerning patient safety, program feasibility, and efficacy for heart failure patients. This suggests a strong potential benefit from such nurse-led interventions.
The authors conclude that these programs are beneficial but also identify important future research directions: further exploring nurses' roles in home-based cardiac rehabilitation, establishing optimal evaluation criteria, and designing safe, effective, and cost-efficient rehabilitation programs suitable for patient populations. The study underscores the significant contribution of nursing to heart failure management through innovative care delivery models.
Critical appraisal
Limitations
- As a scoping review, it summarizes existing evidence rather than generating new primary data or definitive conclusions about specific interventions.
- The study acknowledges that future research will explore optimal evaluation criteria, indicating current assessment methods may not be fully established or standardized.
- While positive outcomes are reported, the abstract does not provide detailed specifics on the magnitude of these benefits (e.g., exact reduction in readmission rates) across all studies reviewed.
Classroom use
Discussion Questions
- What specific roles do nurses play in assessing patients before initiating home-based cardiac rehabilitation?
- How is patient safety monitored and ensured within nurse-coordinated home-based programs?
- What are some potential challenges in implementing a nurse-led home-based cardiac rehab program, and how might they be addressed?
- In what ways can the findings of this scoping review guide future research into optimizing these programs?
- Why is it important to determine optimal evaluation criteria for such rehabilitation programs?
- Discussion question 6: What does "Nurse-coordinated home-based cardiac rehabilitation for patients with heart failure: A scoping review" help nursing students evaluate?
- Discussion question 7: What does "Nurse-coordinated home-based cardiac rehabilitation for patients with heart failure: A scoping review" help nursing students evaluate?
- Discussion question 8: What does "Nurse-coordinated home-based cardiac rehabilitation for patients with heart failure: A scoping review" help nursing students evaluate?
- Discussion question 9: What does "Nurse-coordinated home-based cardiac rehabilitation for patients with heart failure: A scoping review" help nursing students evaluate?
- Discussion question 10: What does "Nurse-coordinated home-based cardiac rehabilitation for patients with heart failure: A scoping review" help nursing students evaluate?
Knowledge check
Quiz
1. What was the primary objective of Ruan et al.'s study?
- To conduct a randomized controlled trial on nurse-led cardiac rehab.
- To summarize existing studies on nurse-coordinated home-based cardiac rehabilitation for heart failure patients.
- To develop new protocols for inpatient cardiac care.
- To compare different types of cardiac medications.
Rationale: The abstract explicitly states the objective was to review and summarize studies, using a scoping review framework.
2. Which methodological approach did the authors use?
- A systematic literature review with meta-analysis.
- A qualitative phenomenological study.
- Arksey and O'Malley’s scoping review framework.
- A prospective cohort study design.
Rationale: The abstract clearly mentions the use of Arksey and O’Malley’s scoping review framework for this particular type of literature synthesis.
3. How many databases were searched to identify relevant studies?
- Four
- Eight
- Twelve
- Sixteen
Rationale: The abstract specifies that a systematic search was conducted across eight databases, including PubMed, Embase, Web of Science, EBSCO, SinoMed, CNKI, Wanfang Database, and Chinese Science and Technology Journals (CSTJ) Database.
4. What were the main activities nurses focused on in these home-based programs?
- Surgical interventions.
- Patient assessment, planning, guidance, and follow-up.
- Pharmacological management only.
- Emergency response training for patients.
Rationale: The abstract states that nurses primarily focused on patient assessment, home-based cardiac rehabilitation planning and guidance, and follow-up.
5. What positive outcomes were reported regarding the nurse-coordinated programs?
- Increased hospital readmissions.
- Negative impact on patient safety.
- Positive outcomes in patient safety, feasibility, and efficacy of the programs.
- No significant change in patient outcomes compared to standard care.
Rationale: The abstract explicitly mentions that studies reported positive outcomes in these areas for the nurse-coordinated programs.
6. What is one key conclusion drawn by the authors about home-based cardiac rehabilitation?
- It is only suitable for patients with mild heart failure.
- It has no role in modern cardiology practice.
- It is beneficial to patients with heart failure.
- Its effectiveness is inconsistent across different patient populations.
Rationale: The abstract concludes that home-based cardiac rehabilitation coordinated by nurses is beneficial to patients with heart failure.
7. What future research direction does the study suggest?
- To explore the potential of nurses in these programs further.
- To develop new surgical techniques for heart failure.
- To focus solely on pharmacological treatments.
- To reduce the role of nurses in cardiac care.
Rationale: The abstract states that future research will explore 'the potential of nurses in home-based cardiac rehabilitation' among other goals like determining optimal evaluation criteria and formulating safe, effective, and economical programs.
8. What is a limitation mentioned or implied by the study type?
- It provides definitive treatment guidelines.
- As a scoping review, it summarizes existing evidence rather than generating new primary data.
- It definitively proves that all nurse-led home rehab programs are equally effective.
- It offers conclusive proof of cost-effectiveness for all such programs.
Rationale: The study is explicitly identified as a 'scoping review,' which by definition aims to map key concepts and types of evidence on a topic, not to generate new primary research findings or definitive conclusions about specific interventions' efficacy in the same way an RCT might.
9. Which aspect did the studies reviewed highlight regarding nurse-coordinated programs?
- Their complexity.
- Their negative impact on patient autonomy.
- Their feasibility and safety.
- Their high cost compared to other options.
Rationale: The abstract reports that 'positive outcomes in patient safety, feasibility, and efficacy of the programs coordinated by nurses' were reported. So, both feasibility and safety are highlighted as positive aspects.
10. What is one key role identified for nurses in this context?
- Performing heart surgeries.
- Leading home-based cardiac rehabilitation planning and guidance.
- Administering all medications to patients at home.
- Replacing physicians entirely in patient care.
Rationale: The abstract states that 'nurses primarily focused on ... home-based cardiac rehabilitation planning and guidance' as one of their main activities within these programs.
Study cards
Flashcards
What was the primary objective of Ruan et al.'s study?
To review and summarize studies of nurse-coordinated home-based cardiac rehabilitation for patients with heart failure.
Which methodological approach did the authors use?
Arksey and O'Malley’s scoping review framework.
How many databases were searched to identify relevant studies?
Eight databases, including PubMed, Embase, Web of Science, EBSCO, SinoMed, CNKI, Wanfang Database, and Chinese Science and Technology Journals (CSTJ) Database.
What was the time frame for the database search?
From inception to 30 April 2023.
How many studies were included in this review?
Eighteen studies were included.
What are the main activities nurses focused on in these home-based programs, according to the abstract?
Patient assessment, home-based cardiac rehabilitation planning and guidance, and follow-up.
What positive outcomes regarding patient safety were reported for nurse-coordinated programs?
Positive outcomes in patient safety of the programs coordinated by nurses were reported.
What is one key conclusion drawn about home-based cardiac rehabilitation?
Home-based cardiac rehabilitation coordinated by nurses is beneficial to patients with heart failure.
What future research direction does the study suggest regarding evaluation criteria?
Future research will determine optimal evaluation criteria for these programs.
What future research direction does the study suggest regarding program formulation?
Future research will formulate safe, effective, and economical rehabilitation programs suitable for patients.
What is a key role identified for nurses in this context (planning/guidance)?
Nurses primarily focused on home-based cardiac rehabilitation planning and guidance.
What type of review was conducted?
A scoping review.
Which journal published the study?
International Journal of Nursing Sciences.
Who are some of the authors mentioned in the source metadata?
Tiantian Ruan, Mengqi Xu, Lingyan Zhu, Yuan Ding.
What is one positive outcome reported regarding feasibility?
Positive outcomes in feasibility of the programs coordinated by nurses were reported.
What is one positive outcome reported regarding efficacy?
Positive outcomes in efficacy of the programs coordinated by nurses were reported.
What does the study suggest about future research on nurse potential?
Future research will explore the potential of nurses in home-based cardiac rehabilitation for patients with heart failure.
What is a limitation mentioned or implied by the study type (scoping review)?
As a scoping review, it summarizes existing evidence rather than generating new primary data or definitive conclusions about specific interventions' efficacy like an RCT might.
What are some of the keywords associated with this paper?
cardiac rehabilitation, heart failure, home care services, nurse, nursing care (among others listed in metadata).
In what year was the study published?
2023-10-01.
Search-ready answers
Frequently asked questions
What is the main focus of Ruan et al.'s scoping review?
The main focus is to summarize existing studies on nurse-coordinated home-based cardiac rehabilitation for patients with heart failure, using Arksey and O'Malley’s framework.
Which databases were used in the systematic search for this review?
Eight databases: PubMed, Embase, Web of Science, EBSCO, China Biomedical Literature Service System (SinoMed), China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Science and Technology Journals (CSTJ) Database.
What were the primary activities nurses focused on in these home-based programs?
Nurses primarily focused on patient assessment, planning and guiding home-based cardiac rehabilitation programs, and providing follow-up care.
What positive outcomes regarding nurse-coordinated programs are reported by the studies included?
The studies report positive outcomes concerning patient safety, feasibility of the programs, and their efficacy for heart failure patients.
What is one key conclusion about home-based cardiac rehabilitation from this review?
A key conclusion is that home-based cardiac rehabilitation coordinated by nurses is beneficial to patients with heart failure.
What future research directions does the study suggest regarding evaluation criteria?
The study suggests future research will determine optimal evaluation criteria for these nurse-coordinated home-based cardiac rehabilitation programs.
What future research direction involves formulating new types of programs?
Future research is also aimed at formulating safe, effective, and economical rehabilitation programs suitable for patients with heart failure in a home setting.
How many studies were included in this scoping review?
Eighteen studies were included in the review.
What type of review methodology was employed by Ruan et al.?
Ruan et al. employed Arksey and O'Malley’s scoping review framework for their study.
In what journal was this research published?
This research was published in the International Journal of Nursing Sciences.