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The Nursing in Practice-Omron UK CVD Online Survey - of more than 800 primary care nurses - showed that 14% had never undertaken any type of basic training in CVD, which is an ongoing and ever-increasing burden on the modern health service.
Heart and circulatory diseases are the UK's biggest killer. In 2004, CVD caused 37% of deaths in the UK, killing over 216,000 people,1 and every day in the UK there are 350 preventable strokes or heart attacks due to high blood pressure. And associated conditions, notably diabetes and obesity, are rarely out of the health media headlines.
Marilyn Eveleigh, consultant editor of the leading journal Nursing in Practice, was surprised by the number of nurses lacking CVD training. "With an average practice caseload having about 10% of registered patients with heart disease, this is sad," she commented. "It should be a core competency of nursing practice and certainly one to include in an induction training programme."
On a positive note, almost 86% of respondents had undertaken some type of basic training in CVD, the most popular being in-house training, with PCT training and reading/web learning not far behind. "I think it is really positive that so many nurses have done some form of training - even if it is fairly basic," commented Linda Goldie, clinical director at the Primary Care Training Centre, Bradford.
Respondents were also asked whether they felt comfortable working with patients with CVD. A resounding 72% answered yes. "Having attended numerous study days over the past four years, along with reading journals and in-house training, I have the confidence to work with patients with cardiovascular conditions," explained a practice nurse from London.
However, 28% answered "no" to this question. "I need more information so that I can offer the correct advice to the patients in my care," replied a community matron from Huddersfield. "The changing roles of the community nurse have come along too fast, and many people are now responsible for cardiovascular reviews who are not adequately qualified but are under pressure to still complete reviews with limited knowledge. I believe this is potentially harmful to the patients in our care."
Marilyn Eveleigh believes that this is a dilemma for many practitioners in a variety of situations: "The NMC code requires all nurses to work within their competency, and each registrant is accountable for their actions."
Linda Goldie agrees: "The community matron's comment is so true. They work as autonomous practitioners, generally with prescribing rights, and they really should be doing much more formal training which assesses knowledge and skills."
Reference
1. Joint British Societies' (JBS 2) guidelines on the prevention of cardiovascular disease in clinical practice were prepared by the British Cardiac Society, British Hypertension Society, Diabetes UK, HEART UK, Primary Care Cardiovascular Society and The Stroke Association.
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