Advanced Practice Registered Nurses’ Role in Cardiovascular Health

Advanced practice registered nurses (APRNs) continue to assume an increasing role in the care of patients with cardiovascular disease. According to an ACC survey of 2,600 APRN members in 2019, 81% worked full-time as direct patient care providers in hospital-based practices in urban areas. The primary responsibilities of survey respondents were:

  • Cardiology consults (65%)
  • Outpatient follow-ups (64%)
  • Hospital rounds (58%)
  • Admission history and physicals (52%)

In recognizing this, the American College of Cardiology (ACC) recently published 2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine in the Journal of the American College of Cardiology. The Steering Committee for this document was largely composed of nurse practitioner (NP) and physician assistant (PA) leaders. The finished document was endorsed by PCNA, along with other major NP and PA professional organizations.

The basis of the document was in recognition of the important role that NPs and PAs play as members of the cardiovascular care team in the diagnosis and management of patients with CVD. It emphasizes the need for prerequisite education, training, experience, and demonstrated competency to function in a collaborative team environment.

This document provides a template for core competencies in Medical Knowledge, Patient Care, and Procedural Skills as it relates to general cardiovascular patient management. It also calls out additional knowledge and skills that may be needed for those NPs and PAs working in sub-specialty practices such as congenital heart disease.

Lisa Maher, DNP, has worked as a Cardiovascular Nurse Practitioner for over 11 years and had this to say:

“My current cardiology knowledge and skills have come through years of study, reading literature, attending conferences, working with my cardiology colleagues, and on the job training. I’m excited that I, along with other Advanced Practice Nurses and Physician Assistants, will have the opportunity to utilize the 2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine as review and learning tools for ourselves as well as younger colleagues.

Although my graduate school did a wonderful job preparing me for graduation and board certification, NP board exams are not specific to specialty practices. Limited clinical hours in Cardiology didn’t allow for the vast knowledge obtained through the completion of a Cardiology Fellowship program. Therefore, allowing NP’s to review the wide scope of Cardiology through the different competencies is an amazing opportunity and learning experience.

The ACC Clinical Competencies for Nurse Practitioners and Physician Assistants will help improve the standard of care within Cardiology practices that will likely lead to better patient outcomes as well.”

And, it sounds a call to NPs to rise to the challenge of this expanding role in cardiology.

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