The impact of a nurse‐led elective direct current cardioversion in atrial fibrillation on patient outcomes: A systematic review

Abstract

Aims and objectives To examine and present the success rate in relation to nurse‐led elective DCCV service in AF patients. Background As the incidence of AF increases healthcare settings will continue to face challenges in providing appropriate timely intervention. The provision of DCCV has primarily been medical‐led. Due to the increasing requirement of hospital beds, cost restriction and medical team stress the roles of nurse specialists have been driven to include elective DCCV. Design A systematic review with a narrative synthesis was undertaken. Methods The databases searched include the following: The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Embase, Clinical Key, Web of Science, Cochrane Library and HSE library website. A total of 187 articles were identified, and seven studies were included for synthesis. The EBL checklist was used to assess validity. The PRISMA checklist was used for transparency. Results The results of this review show an acceptable complication rate, no negative patient outcomes and a high rhythm conversion success rate. A disparity was identified due to the lack of distinction between registered nurse (RGN), advanced nurse practitioner (ANP), advanced practice provider (APP) and nurse practitioner (NP) roles. These results support the belief that a highly skilled nurse in this specific background working in a supportive organisational framework can make a valuable contribution to such practices. Conclusion A structured nurse‐led elective DCCV service appears safe, effective and has a high success rate in restoration to sinus rhythm in AF. However, the need for further research in order to advance knowledge and support changes in nurse‐led DCCV practice is evident. Relevance to clinical practice This review demonstrates that a nurse‐led elective DCCV service appears safe and successful in restoring sinus rhythm. It has promising potential effects in terms of waiting time, cost saving and achieving patient satisfaction.

Current state of knowledge around nurse-led cardioversion: a launchpad for future projects

“…As our populations age, there will be increasing numbers of patients with atrial fibrillation across the globe 5. The current study2 certainly supports nurse-led cardioversion clinics in various formats. Furthermore, this work highlights the movement of nursing professionals into practice areas that have traditionally been the domain of medicine.…”

“…The researchers sought to conduct a meta-analysis focused on patient outcomes related to elective nurse-led direct current cardioversion for atrial fibrillation 2. The key variable was the success rate of nurse and nurse practitioner led direct current cardioversion in atrial fibrillation as indicated by a return to normal sinus rhythm.…”

“…Direct current cardioversion is an electrical cardiac treatment used to reset heart rhythms in some patients with atrial fibrillation 1. While direct current cardioversion had historically been medically led, increased demand for the treatment has led to the development of nurse-led services 2. Nurse and nurse practitioner led cardioversion clinics will be seen more often as our populations age.…”

The Importance of Strategy in Healthcare

“…Due to the increasing requirement for hospital beds, cost restriction and medical teams, the roles of nurse specialists have been driven to include new areas of practice (Carney and Crosssan (). Manoj and Moore, Moore, Patton, O'Connor and Nugent () found the success rate of nurse‐led elective DCCV service in atrial fibrillation (AF) patients supports the belief that a highly skilled nurse in this specific background, working in a supportive organizational framework, can make a valuable, safe contribution to such practices by having a high success rate in restoration to sinus rhythm in AF. Lavery and Tracy () demonstrate how ANPs in the UK have expanded their role to include performing lumbar puncture with resultant benefits for patients and medical colleagues.…”

Collaborative strategic initiative between a university and hospital network group: Advanced nurse/midwife practice forum

“…As the incidence of atrial fibrillation increases, health care settings will continue to face challenges in providing appropriate timely intervention which up to now have been mainly medical led. Manoj, Moore, Patton, O'Connor, and Nugent (2019) explored the impact of a nurse‐led elective direct current cardioversion (DCC) in atrial fibrillation on patient outcomes, in Ireland. Results indicated positive patient outcomes and a high rhythm conversion success rate.…”