Exploring the role of the nurse in preventing and controlling risks factors in cardiovascular disease

Exploring the role of the nurse in preventing and controlling risks factors in cardiovascular disease

Nurses are in a unique position to diagnose and treat human responses to actual or potential health problems. The nurse practitioner can have a positive impact on the prevention and management of cardiovascular disease through patient education and counseling.  Nurse Practitioners are oftentimes the first healthcare provider seen when there is a new patient.  The Nurse Practitioner conducts the initial evaluation and sets up the care plan which includes primary and secondary prevention strategies.

The success of your patient teaching plan is measured through the patient’s compliance to the prescribed treatment plan.  Your teaching should be set up with goals that will enhance compliance. You need to make the assessment with the patient and family to focus on maximum compliance. Each visit should incorporate a review of the goals that were set and examples of how the patient is meeting or not meeting those goals. When you are following up during your visit to assess the success, if the patient has not followed the plan ask for the patient’s help to identify what is preventing him from being successful and revise the plan based on revised goals (Solomon, 2000). If the patient has even had small successes it is important to congratulate them and focus on those positives as you reformulate goals.  Provide the patient with resources to help support his plan. Remember that there are many references out there in the internet. Some are not so accurate, that may have just the opposite effect you and the patient are trying to achieve. By providing the patient with a take home list of resources you can be sure the information is the right information for the patient [http://nursesaregreat.com/articles/rrfh.htm]. 

The ICSI Health Care Guideline was designed to assist clinicians by providing an analytical framework for the evaluation and treatment of patients, and is not intended either to replace a clinician’s judgment or to establish a protocol for all patients with a particular condition.  The guideline outlines the existing evidence for the effectiveness of strategies and programs designed to help adults successfully make essential changes to achieve healthier lifestyles (increased physical activity, improved nutrition, decreased tobacco use and exposure, decreased hazardous and harmful drinking/alcohol use). It also outlines how these programs might be integrated into preventive services in health care systems, which traditionally have focused on early detection of disease or treatment of risk factors rather than preventing the onset of risk factors.
Nearly all individuals would derive measurable benefits from healthier lifestyles; even small improvements across a large portion of the population would have a greater impact than focusing on a small portion of the population that is at the upper end of the risk distribution. Therefore, the target population for this guideline includes all adults (age 18 and older) in the community, irrespective of their utilization of the health care system. Although this guideline focuses on adults, adolescents and children may benefit from many of the components or recommendations in this guideline [http://www.icsi.org/chronic_disease_risk_factors__primary_prevention_of__guideline__23506/chronic_disease_risk_factors__primary_prevention_of__guideline__23508.html].
Nurse practitioners should follow these guidelines to create a successful educational plan for their patients.  They should teach the following four lifestyle behaviors –

1.    adequate physical activity

2.    a diet that emphasizes fruits and vegetables

3.    abstinence from tobacco and avoidance of tobacco smoke

4.    avoidance of hazardous and harmful drinking

These are associated with a decade or more of increased life expectancy. Individuals, who adopt this lifestyle, at any age, have significantly lower total mortality rates [http://www.icsi.org/chronic_disease_risk_factors__primary_prevention_of__guideline__23506/chronic_disease_risk_factors__primary_prevention_of__guideline__23508.html].

After you begin your teaching plan it is important for compliance and success to evaluate where you are. This allows you and the patient to reset goals and stay on target. It will ensure greater success (Patient Teaching, 2001). Evaluation of lifestyle changes should be part of each visit to help the patient stay on track. Follow-up visits are planned based on patient needs. For example if you have a patient with elevated blood pressure and you are using lifestyle modification as an initial treatment plan you may want an every two week follow-up. For many patients a more realistic follow up is monthly. Evaluation and revision of the teaching plan is part of every visit [http://nursesaregreat.com/articles/rrfh.htm].

 

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