Letter From Our President, Cheryl Dennison Himmelfarb, PhD, RN, ANP, FAHA, FPCNA, FAAN, Associate Professor, Johns Hopkins University
I am honored and enthusiastic as I begin my term as president of the Preventive Cardiovascular Nurses Association (PCNA). I am committed to advancing the role and recognition of nurses as leaders in cardiovascular disease prevention.
Cardiovascular disease remains the primary cause of death and disability in men and women worldwide. Nearly 84 million adults, including men and women of all races in the United States, are currently living with some form of cardiovascular disease—and this number is expected to rise.1 However, we have seen the number of deaths attributable to cardiovascular disease in the United States decrease over the last decade. And by 1 estimate, 47% of the decrease was a result of increased use of evidence-based interventions targeted at secondary prevention, and 44% to changes in risk factors in the population related to lifestyle and environmental changes.1,2 I have no doubt that PCNA, an organization with a robust network of partnerships, alliances, and highly engaged members, has contributed substantially to the improvements we have seen in the last decade and will continue as a leading organization in the fight to prevent cardiovascular disease.
The increasing global burden of cardiovascular disease, an expanding ethnically diverse population, and an aging population with multiple comorbidities characterize today’s complex healthcare environment. These transitions provide an abundance of challenges and opportunities for cardiovascular nurses and advanced practice nurses to provide leadership in the prevention and management of cardiovascular disease. I am currently representing PCNA on a group of cardiovascular nursing leaders to update the Cardiovascular Nursing: Scope and Standards of Practice.3 The group delineated the following key elements of cardiovascular nursing: (1) development of programs that promote heart health; (2) education and counseling about heart health; (3) interventions that reduce risk factors; (4) individualized evidence-based interventions that maintain or improve physiologic, psychological, and psychosocial health; (5) interventions that facilitate and optimize behavioral change and treatment adherence over time; (6) conducting research; and (7) advocacy to support patients and families during the planning, implementation, and evaluation of their care. Excellence in cardiovascular nursing requires advanced cardiovascular knowledge and skills. PCNA is committed to the continuing education and support of nurses so they may successfully rise to this challenge.
I continue to gain personally and professionally through my involvement in our vibrant organization. I encourage you to increase your involvement in PCNA. There are numerous opportunities to enhance your cardiovascular nursing practice and leadership through our webinars, regional and chapter meetings, and our annual symposium. I invite you to use PCNA’s extensive online education and clinical tools, including exceptional patient education resources, and let us know if there are educational programs or products you would like to see added. I urge you to publish your research and clinical papers in the Journal of Cardiovascular Nursing (JCN), which is recognized internationally for its excellence and broad coverage of important cardiovascular topics. Let us know how we can improve our communication with you and provide you with the tools to better serve your patients and your community. Join us on Twitter and Facebook. Help us to ensure that PCNA is meeting your needs as you lead efforts to improve cardiovascular disease prevention and management.
1. American Heart Association. Update on Heart Disease and Stroke Statistics. 2015. http://circ.ahajournals.org/content/early/2014/12/18/CIR.0000000000000152.full.pdf+html. Accessed February 28, 2015.
2. Ford ES, Ajani UA, Croft JB et al. Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med. 2007;356:2388–2398.
3. American Nurses Association and American College of Cardiology Foundation. Cardiovascular Nursing: Scope and Standards of Practice. Silver Spring, MD: Nursesbooks.org; 2008.
Rocky Mountain Chapter Initiative: A Unique Approach to Sharing Knowledge Among Chapter Members
In January 2015, the PCNA Rocky Mountain Chapter was able to pilot a Journal Club event that had been in the planning stages for a year. The first session was a success, with 12 attendees who were members and nonmembers of PCNA. We were able to create a positive environment for professional enhancement, promotion of evidence-based practice, and an opportunity to network with other nurses in the region. The chapter will continue to host future Journal Club events with a goal to provide a meeting 3 to 4 times within the year. A long-term goal for the chapter is to create a model Journal Club format that can translate to multiple venues throughout the region and to eventually include WebEx viewing for accessibility for participants.
The Journal Club is an effort to involve chapter members in facilitating discussion on innovative care and to review current regional care practices and increase opportunities for involvement of chapter members.
Below are a few steps to assist other chapters that may be looking for an inexpensive and effective way to reach out to current and potential members.
- 1. Gather a motivated core group to initiate the club.
- 2. Set a date, place, and time (about 1 month before the event).
- Tip: Location could be FREE at a hospital at which a host works, in a local library, or, for a small group, someone’s home.
- 3. Choose a topic for the first journal club (about 1 month before the event).
- Tip: The Rocky Mountain Chapter’s first topic was “Heart Failure on a Continuum.”
- 4. Choose articles from online access to JCN that fit the topic (send out to participants a week before the event).
- 5. Choose a host to direct conversation and to review articles.
- 6. Invite and advertise to current members, to coworkers, and to colleagues with RSVPs.
- 7. Serve light refreshments.
- Tip: Heart-healthy choices!
- 8. Host arrives early to welcome participants.
- 9. Have participants complete a postsurvey for suggestions and comments after the event to gain insight for future topics, discover improvements to the process, and identify participants who would be interested in returning for a second event.
What Can We Do to Improve Care Beyond National Minority Health Month?
April is National Minority Health Month and brings our awareness to health disparities, but what can we do to improve care beyond this month? The term disparities incorporates many areas that have an effect on healthcare delivery, including “race, ethnicity, sex, sexual identity, age, disability, socioeconomic status, education and geographic location.”1 Although the problem of healthcare disparities has been present for centuries, the evidence suggests that there continues to be disproportionate care with some groups. Each decade, Healthy People has expanded the goal. In Healthy People 2000, the goal was reduction of disparities. In Healthy People 2010, the goal was to eliminate disparities, and in Healthy People 2020, the goal has been expanded to healthy equity for all groups. Health equity is defined as “attainment of the highest level of health for all people.” This requires valuing all people equally and continuing to work with the societal influences to avoid inequalities and eventually to eliminate healthcare disparities.1
The problem of healthcare disparities is complex. We do know that individual behavior, socioeconomic status, and literacy levels are some of the factors that influence health. While we wait for global solutions, there are some things that we can do in our practices or communities or both.
Ideas for nurses and advanced practice nurses to improve healthcare for all are as follows:
- Start educational programs in your communities, churches, pharmacies, community centers, schools, senior centers; request that your hospital sponsor educational sessions throughout the year.
- Partner with your local PCNA chapter and offer an educational topic for the community.
- Use the free PCNA patient education materials for handouts. The Heart Healthy Toolbox with examples of healthy eating, shopping on a budget, exercise and physical activity, successful behavior change, and motivational interviewing are just a few of the educational tools available.2
1. HealthyPeople.gov. Disparities. www.healthypeople.gov/2020/about/foundation-health-measures/Disparities. Accessed February 15, 2015.
2. PCNA Web site. www.pcna.net. Accessed February 15, 2015.
Preventive Cardiovascular Nurses Association’s Leadership on Hypertension Continues
Despite significant increases over the past 10 years in hypertension awareness, treatment, and control among adults with hypertension, the percentage of hypertensive patients whose blood pressure is under control remains around 50%. PCNA recognizes the role of nurses in educating patients and the public on the role of hypertension as a risk factor for heart attack, brain attack, and heart failure. We are proud to be 1 of 11 groups (as well as the only nursing organization) involved in developing the new guidelines for the management of hypertension, an effort led by the American College of Cardiology and the American Heart Association. This will serve as an update to the 2003 JNC-7 (Seventh Report of the Joint National Committee on Prevention, Evaluation, and Treatment of High Blood Pressure) and is expected to be published in 2016. PCNA is also excited to be partnering with the American Society of Hypertension on a joint session at their Annual Scientific Meeting in May 2015 in New York City. Learn more at http://www.ash-us.org/Scientific-Meetings.aspx.
PCNA also champions the role of the patient as a partner in blood pressure management. In 2008, PCNA, along with the American Heart Association and American Society of Hypertension, issued Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring. Our patient education materials also reflect the importance of patient engagement. The latest iteration of the brochure How Do You Measure Up? includes a pull-out tape measure within the brochure that can be used to determine correct cuff size. PCNA also has a 1-page fact sheet, available in both English and Spanish, that has been featured on the Million Hearts Web site.
Visit the PCNA Web site to order or download these materials to use in the clinical or public health settings.
New Continuing Education Available
It was great to see so many old friends and new PCNA members at our Annual Symposium in Anaheim in April. We recognize that our members meet their continuing education needs in multiple ways. The online learning management system of PCNA offers more than 30 on-demand programs that can help meet your needs at times that work for you, and most have free registration (http://pcna.net/online-education).
Check out some of our newer selections:
- Acute Coronary Syndrome: Safe Transition to Home…and Health
- Patient Advocacy in Post-Hospitalization Care of ACS: Closing Communication Gaps and Engaging Patients
- Optimal Strategies to Reduce Cardioembolic Risk in the Patient with Nonvalvular Atrial Fibrillation: A Patient-Centered Approach