Online Forms Guide
Medical Evaluation Forms, Assessment Tools, and Educational Materials
PCNA's Online Forms Guide includes downloadable PDF templates of clinical forms and patient handouts that you can use in your CVD risk reduction practice. These forms can be integrated into patient medical records; they include patient assessment forms, contracts, flow charts, follow-up plans & tools, patient-education materials, and a list of online resources.
THIS IS A MEMBER-ONLY TOOL!
MEMBERS: Log-in to your PCNA Portal above OR click "Your Account" if currently logged-in to access the "Forms Guide" tab in your PCNA Portal
TABLE OF CONTENTS:
|I. ||Patient Assessment |
|II. ||Flow Charts |
|III. ||Contracts and Self-Monitoring Logs |
|IV. ||Drug Information Sheets for Patients |
| ||• ||Anti-Hypertension Agents |
| ||• ||Anti-Anginal Medications |
| ||• ||Anti-Platelet/Anti-Coagulation |
| ||• ||Lipid Lowering Agents |
| ||• ||Diabetic-Oral Anti-Hyperglycemia Agents |
| ||• ||Smoking Cessation Aids |
| ||• ||Weight Loss Aids |
|V. ||Evaluation Tools |
|VI. ||Peripheral Arterial Disease |
|VII. ||Diabetes |
|VIII. ||Nutrition |
|IX. ||Stress Management |
|X. ||Follow-Up Tools |
|XI. ||Patient Education |
|XII. ||Exercise |
|XIII. ||Information on Smoking Cessation |
|XIV. ||Medication Adherence |
|XV. ||Hypertension - Ambulatory and Home Blood Pressure Monitoring |
|XVI. ||Models of Behavior |
|XVII. ||Searching the Internet for Cardiovascular Resources |
|XVIII. ||Lipid Reference Values |
The audience for this program will be primarily nurses and nurse practitioners specializing in cardiovascular risk assessment, risk reduction, and disease management.
Janet Long, MSN, ANCP, CLS, FAHA, FPCNA
Nurse Practitioner, Co-Director Cardiovascular Risk Reduction Program
Rhode Island Cardiology Center
Cindy Lamendola, MSN, ANP-BC, FAHA, FPCNA
Clinical Research Coordinator
Stanford University School of Medicine
Stanford University Medical Center
Jane Nelson Worel, MSN, APRN-BC, APNP, FAACVPR, FPCNA
Phases, Primary healthCare for Women
Jane Linderbaum, NP
Family Nurse Practitioner
Kenneth A. Kellick, PharmD
Clinical Pharmacy Coordinator
VA Western NY Healthcare System
Nancy Houston Miller, RN, BSN, FAHA, FPCNA
Stanford Cardiac Rehabilitation Program
Palo Alto, CA
This tool is supported by an educational grant from Merck/Schering-Plough and by a grant by the Hartford Institute for Geriatric Nursing at the New York University College of Nursing as part of an initiative called REASN, (Resourcefully Enhancing Aging in Specialty Nursing). The REASN initiative is funded with a $2.3 million dollar grant from The Atlantic Philanthropies (USA) Inc.
This online educational activity is offered free of charge.
To access the Table of Contents, you will need to register or log in using the link at the top of this page. Once you are logged in, you can view the Table of Contents and select individual forms or multiple forms by section. Many of these forms may be customized to include your organization's name, telephone number, and other important information in the editable fields as indicated. Once downloaded, these forms may be printed for one-time or multiple-time use.
PCNA hopes that these forms will enhance your practice by allowing you to provide the best care to your patients by reducing their cardiovascular risk factors and help them reach treatment goals.
Please be aware that these forms include a sample of current clinical guidelines. However, clinical guidelines (federal, state, local, or those issued by clinical organizations) change over time, so the reader should remember to investigate any recent legal or clinical developments.
Section 4 of these Forms contains lists and information on commonly used medications. These lists and the information about the medications are not meant to be exhaustive. Consult complete guidelines for a more comprehensive review of indications and clinical follow-up recommendations. All patients should be evaluated based on their state of health, co-morbidities, and other criteria that would guide choices of medical therapy.