Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical.

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Presentation transcript:

Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical Center / University of Applied Sciences Amsterdam

Health Care Challenges

Europe is ageing rapidly

Proportion of 65+ years of age % 65+ ▬ European Region ▬ EU-10 ▬ European Union ▬ EU-15 ▬ CIS ║

Age pyramid for Europe in 2008 Age MenWomen Numbers per million

Age pyramid for Europe in 2050 Age MenWomen Numbers per million

↑ Age = ↑ Disease burden

Major causes of death by age ≥90Total AGE

Increasing number of hospital discharges

Hospital Discharge Cardiovascular Disease No / 1,000 inhabitants ▬ European Region ▬ EU-10 ▬ European Union ▬ EU-15 ▬ CIS ║

Length of Hospital Stay Days ▬ European Region ▬ EU-10 ▬ European Union ▬ EU-15 ▬ CIS ║

Older patients often suffer from comorbidity

Underlying Heart Diseases in AFib %

Number of underlying Heart Diseases

Increasing number of persons at risk

Prevalence of Diabetes in Adults (Age 20-29) %

% Improved Secondary Prevention since 1995 Antithrombotics Lipid lowering Beta-blockers ACE-I/ARB Surveys

EUROASPIRE Surveys Pharmacological Treatment %

EUROASPIRE Surveys Lifestyle %

Also increasing number of caregivers ?

10 to 14 6 to 10 2 to 3 3 to 6 14 to 19 No data NURSES PER 1,000 INHABITANTS 6.8 nurses to 1 physician in Ireland 0.5 nurses to 1 physician in Italy 4.5 nurses to 1 physician in the Netherlands

Our Nurse Led Clinic Satellite Clinic of the Academic Hospital

Borders Patient care Education Research

Crossing borders EducationResearchPatient care

Crossing borders EducationResearchPatient care

Evidence Based Care

Multidisciplinary Care

28 Why cardiovascular care?

29 Why cardiovascular care? Expertise Complex & Multidisciplinary care High prevalence Facilities available Good financial possibilities

RESPONSE Trial: nurse led secondary prevention clinics

RESPONSE Trial - Intervention 4 visits in 6 months Cardiovascular risk monitoring Care coordination Medical therapy Lifestyle counseling Adherence Screening diabetes

RESPONSE Trial

RESPONSE 2 Trial Shared Decision Making