Advertisement
Research Article| Volume 58, P82-90, March 2023

Nurses’ knowledge of heart failure assessment and management: A cross-sectional survey

Published:November 23, 2022DOI:https://doi.org/10.1016/j.hrtlng.2022.11.008

      Highlights

      • Specialist nurses are not only more knowledge but their knowledge levels are less variable compared to those among generalist nurses in caring for patients with heart failure.
      • Specialist nurses may not be sufficiently knowledgeable in daily weight monitoring, comparison of weights, and hypotension.
      • The knowledge levels of specialist nurses were significantly impacted by race and confidence level; in contract, the knowledge levels for generalist nurses were likely to be influenced by race and years of experience in taking care of patients with heart failure.
      • Qualitative themes were demonstrated and addressed critical knowledge barriers to insufficient heart failure knowledge among nurses.

      Abstract

      Background

      Nurses’ knowledge of heart failure (HF) is highly variable, ranging from expert to poor, potentially leading to inadequate self-care.

      Objectives

      (1) document the knowledge variation of HF assessment and management among specialist and generalist nurses; (2) determine factors that may be associated with nurses’ knowledge; and (3) describe nurses’ views of knowledge deficits and ways to improve nurses’ knowledge to better meet the needs educational interventions.

      Method

      Members of the American Association of Heart Failure Nurses and Registered Nurses were invited to participate in a cross-sectional survey. Independent samples t-test, chi-square, and linear regression were used for quantitative analysis. Text analysis was applied to analyze the themes of qualitative comments.

      Results

      A total of 918 nurses completed the survey. Specialist nurses had higher scores than generalist nurses with statistically significant F-test for diet, fluid, signs/symptoms, medication, and exercise. Both specialist and generalist nurses were least knowledgeable about dry weight, asymptomatic hypotension, and transient dizziness. Being a specialist nurse was associated with higher level of knowledge scores. Years of experience and race were significant factors associated with knowledge scores in generalist nurses. Confidence level and race were significant predictors for specialist nurses. Three themes emerged regarding the cause of nurses’ insufficient knowledge and several approaches were provided.

      Conclusions

      Specialist nurses are not only knowledgeable, but their knowledge levels are less variable compared to generalist nurses. There is a need to identify additional factors that may potentially influence nurses’ knowledge, contributing to the effectiveness of interventions.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart & Lung: The Journal of Cardiopulmonary and Acute Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Benjamin E.J.
        • Virani S.S.
        • Callaway C.W.
        • et al.
        Heart disease and stroke statistics - 2018 update: a report from the American heart association.
        Circulation. 2018; 137https://doi.org/10.1161/CIR.0000000000000558
      1. Benjamin E.J., Virani S.S., Callaway C.W., et al. Heart disease and stroke statistics—2017 update. Vol 135.; 2017. doi:10.1161/CIR.0000000000000485.Heart

        • Dharmarajan K.
        • Hsieh A.F.
        • Kulkarni V.T.
        • et al.
        Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study.
        BMJ. 2015; 350: h411https://doi.org/10.1136/bmj.h411
        • Dharmarajan K.
        • Rich M.W.
        Epidemiology, pathophysiology, and prognosis of heart failure in older adults.
        Heart Fail Clin. 2017; 13: 417-426https://doi.org/10.1016/j.hfc.2017.02.001
        • Ryan C.J.
        • Bierle R.
        The three Rs for preventing heart failure readmission: review, reassess, and reeducate.
        Crit Care Nurse. 2019; 39: 85-93
        • Sevilla-Cazes J.
        • Ahmad F.S.
        • Bowles K.H.
        • et al.
        Heart failure home management challenges and reasons for readmission: a qualitative study to understand the patient's perspective.
        JGIM J Gen Intern Med. 2018; 33: 1700-1707https://doi.org/10.1007/s11606-018-4542-3
        • Riegel B.
        • Moser D.K.
        • Buck H.G.
        • et al.
        Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American heart association.
        J Am Heart Assoc. 2017; 6https://doi.org/10.1161/JAHA.117.006997
        • Riegel B.
        • Dunbar S.B.
        • Fitzsimons D.
        • et al.
        Self-care research: where are we now? Where are we going?.
        Int J Nurs Stud. 2021; 116103402
        • Son Y.J.
        • Choi J.
        • Lee H.J.
        Effectiveness of nurse-led heart failure self-care education on health outcomes of heart failure patients: a systematic review and meta-analysis.
        Int J Environ Res Public Health. 2020; 17: 6559
        • Mahramus T.L.
        • Penoyer D.A.
        • Lou Sole M
        • Wilson D.
        • Chamberlain L.
        • Warrington W
        Clinical nurse specialist assessment of nurses’ knowledge of heart failure.
        Clin Nurse Spec. 2013; 27: 198-204https://doi.org/10.1097/NUR.0b013e3182955735
        • Albert N.M.
        • Collier S.
        • Sumodi V.
        • et al.
        Nurses’ knowledge of heart failure education principles.
        Hear Lung J Acute Crit Care. 2002; 31: 102-112https://doi.org/10.1067/mhl.2002.122837
        • Hart P.L.
        • Spiva L.
        • Kimble L.P.
        Nurses’ knowledge of heart failure education principles survey: a psychometric study.
        J Clin Nurs. 2011; 20: 3020-3028https://doi.org/10.1111/j.1365-2702.2011.03717.x
        • Washburn S.C.
        • Hornberger C.A.
        • Klutman A.
        • Skinner L.
        Nurses’ knowledge of heart failure education topics as reported in a small midwestern community hospital.
        J Cardiovasc Nurs. 2005; 20: 215-220https://doi.org/10.1097/00005082-200505000-00014
        • Willette E.W.
        • Surrells D.
        • Davis L.L.
        • Bush C.T.
        Nurses’ knowledge of heart failure self-management.
        Prog Cardiovasc Nurs. 2007; 22: 190-195https://doi.org/10.1111/j.0889-7204.2007.06403.x
        • Fowler S.
        Improving community health nurses’ knowledge of heart failure education principles: a descriptive study.
        Home Healthc Nurse. 2012; 30: 91-99
        • Krówczyńska D.
        • Jankowska-Polańska B.
        Nurses as educators in the comprehensive heart failure care programme—are we ready for it?.
        Nurs Open. 2020; 7 (1354–1366): 1354-1366https://doi.org/10.1002/nop2.507
        • Buck H.G.
        • Harkness K.
        • Wion R.
        • et al.
        Caregivers' contributions to heart failure self-care: a systematic review.
        Eur J Cardiovasc Nurs. 2015; 14: 79-89https://doi.org/10.1177/1474515113518434
        • Anderson K.M.
        • Bither C.
        • Andon N.
        The American association of heart failure nurses (AAHFN) certification review course: the impact on heart failure nurses’ knowledge.
        Heart Lung. 2018; 47: 166-168https://doi.org/10.1016/j.hrtlng.2018.01.002
        • Stamp K.D.
        • Machado M.A.
        • Allen N.A.
        Transitional care programs improve outcomes for heart failure patients: an integrative review.
        J Cardiovasc Nurs. 2014; 29: 140-154https://doi.org/10.1097/JCN.0b013e31827db560
        • Nguemeni Tiako M.J.
        • Ray V.
        • South E.C
        Medical schools as racialized organizations: how race-neutral structures sustain racial inequality in medical education-a narrative review.
        J Gen Intern Med. 2022; 37: 2259-2266https://doi.org/10.1007/s11606-022-07500-w
        • Offredy M.
        • Kendall S.
        • Goodman C
        The use of cognitive continuum theory and patient scenarios to explore nurse prescribers’ pharmacological knowledge and decision-making.
        Int J Nurs Stud. 2008; 45: 855-868https://doi.org/10.1016/j.ijnurstu.2007.01.014
        • Brenne B.A.
        • Hedlund M.
        • Ingstad K.
        Exploring home-based care nurses' mindset for nursing practices: a phenomenological study.
        BMC Nurs. 2022; 21: 291https://doi.org/10.1186/s12912-022-01068-w
        • Nelson-Brantley H.V.
        • Bailey K.D.
        • Batcheller J.
        • et al.
        Nurses taking the lead: a look back to move forward.
        J Nurs Adm. 2021; 51: 120-122https://doi.org/10.1097/NNA.0000000000000980
        • Wang Z.
        • Tocchi C.
        Partners' experience of informal caregiving for patients with heart failure: a meta-ethnography.
        J Cardiovasc Nurs. 2022; (Advance online publication)https://doi.org/10.1097/JCN.0000000000000903