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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 on theme: "Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical."— Presentation transcript:

1 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

2 Health Care Challenges

3 Europe is ageing rapidly

4 Proportion of 65+ years of age 0 10 15 20 % 65+ ▬ European Region ▬ EU-10 ▬ European Union ▬ EU-15 ▬ CIS ║ 1980198519901995200020052010

5 Age pyramid for Europe in 2008 Age MenWomen 432101234 Numbers per million 90+ 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0

6 Age pyramid for Europe in 2050 Age MenWomen 432101234 Numbers per million 90+ 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0

7 ↑ Age = ↑ Disease burden

8 Major causes of death by age 01020 30 4050607080≥90Total AGE

9 Increasing number of hospital discharges

10 Hospital Discharge Cardiovascular Disease No / 1,000 inhabitants ▬ European Region ▬ EU-10 ▬ European Union ▬ EU-15 ▬ CIS 0 25 35 20 30 15 ║ 1990 1995 2000 2005 2010

11 Length of Hospital Stay Days ▬ European Region ▬ EU-10 ▬ European Union ▬ EU-15 ▬ CIS 0 12 18 10 16 8 ║ 14 1985 1990 1995 2000 2005 2010

12 Older patients often suffer from comorbidity

13 Underlying Heart Diseases in AFib %

14 Number of underlying Heart Diseases

15 Increasing number of persons at risk

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

17 % Improved Secondary Prevention since 1995 Antithrombotics Lipid lowering Beta-blockers ACE-I/ARB Surveys 19952005-2006

18 EUROASPIRE Surveys Pharmacological Treatment %

19 EUROASPIRE Surveys Lifestyle %

20 Also increasing number of caregivers ?

21 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

22 Our Nurse Led Clinic Satellite Clinic of the Academic Hospital

23 Borders Patient care Education Research

24 Crossing borders EducationResearchPatient care

25 Crossing borders EducationResearchPatient care

26 Evidence Based Care

27 Multidisciplinary Care

28 28 Why cardiovascular care?

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

30

31 RESPONSE Trial: nurse led secondary prevention clinics

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

33 RESPONSE Trial

34 RESPONSE 2 Trial Shared Decision Making

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