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Clinical Nurse Specialist Assessment of Nurses’ Knowledge of Heart Failure

Mahramus, Tara L. MSN, RN, CNS, CCNS, CCRN; Penoyer, Daleen Aragon PhD, RN, CCRP, FCCM; Sole, Mary Lou PhD, RN, CCNS, FAAN, FCCM; Wilson, Debra RN-BC, COS-C; Chamberlain, Lyne MSN, CNS, CCRN-CMC, CCNS; Warrington, William PhD, RN, CCRP

doi: 10.1097/NUR.0b013e3182955735
Feature Article

Purpose/Objective: Patients’ self-management of heart failure (HF) is associated with improved adherence and reduced readmissions. Nurses’ knowledge about self-management of HF may influence their ability to adequately perform discharge education. Inadequate nurse knowledge may lead to insufficient patient education, and insufficient education may decrease patients’ ability to perform self-management. Prior to developing interventions to improve patient education, clinical nurse specialists should assess nurses’ knowledge of HF. The purpose of this study was to determine nurses’ knowledge of HF self-management principles.

Design: This was a prospective, exploratory, and descriptive online test.

Settings: There were 3 patient care settings: tertiary care teaching hospital, community hospital, and home healthcare division.

Sample: The sample was composed of 90 registered nurses who worked directly with patients with HF.

Methods: Nurses completed an online test of knowledge using the Nurses’ Knowledge of Heart Failure Education Principles instrument.

Findings: Registered nurses (n = 90) completed the knowledge test instrument; their average score was 71% (SD, 10.8%) (range, 20%–90%). The percentage of correct items on each subscale ranged from 63.9% (SD, 30.0) for medications to 83.3% (SD, 25.0) for exercise. Only 8.9% of respondents achieved a passing score of greater than 85%, and a passing score was not associated with any demographic characteristics.

Conclusions: Overall, nursing knowledge of HF self-management principles was low. Scores from our nurses were similar to those found in other studies.

Implications: There is a need to develop interventions to improve nursing knowledge of HF self-management principles. Clinical nurse specialists can be instrumental in developing knowledge interventions for nurses.

Author Affiliations: Clinical Nurse Specialist, Orlando Regional Medical Center (Ms Mahramus), Florida; Director (Dr Penoyer) and Nurse Scientist (Dr Warrington), Center for Nursing Research, Orlando Health, Florida; Orlando Health Distinguished Professor, University of Central Florida College of Nursing (Dr Sole); Clinical Manager, Visiting Nurses Association, Orlando, Florida (Ms Wilson); and Clinical Nurse Specialist for Cardiology, Dr P. Phillips Hospital of Orlando Health (Ms Chamberlain), Florida.

The authors report no conflicts of interest.

Correspondence: Tara L. Mahramus, MSN, RN, CNS, CCNS, CCRN, 1414 Kuhl Avenue, MP 107, Orlando, FL 32806 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins