Organisation of care for Swedish patients with an Implantable Cardioverter Defibrillator, a national survey

• Aim: To describe the clinical aspects of Implantable Cardioverter Defibrillators (ICD) care in Sweden with focus on organisation, the role and education of nurses, patient information and education, and areas in need of improvement. Background: ICD implantations have developed rapidly in recent years and is now an established arrhythmia treatment. The expanding indication for ICD implantation demands new competencies and resources in the ICD team members. Methods: Participants were recruited among physicians and nurses in all of the hospitals implanting ICDs (N=16). Data was collected by a questionnaire. Additionally, all written educational materials provided to patients pre- and post-implant were collected from all 16 hospitals. Deductive content analysis using Sarvimäki and Stenbock-Hult’s five holistic dimensions was employed to ascertain how information was provided in brochures and information materials. Results: Half of the hospitals (n=8) had nurse-based outpatient clinics and several others planned to introduce them. Three hospitals carried out distance follow-ups by means of telemonitoring. The nurses had received specific ICD education from ICD companies and/or various university courses. The biophysical dimension dominated in the information material while the emotional, intellectual, and socio-cultural dimensions were scarcely described, and the spiritual- existential was not referred to at all. Conclusion: Holistic care of ICD patients can be achieved by means of a multi-disciplinary ICD team and more patient-centred educational strategies. In Sweden, the organisation of ICD care and follow-up is developing towards more nurse-based clinics. Relevance to clinical practice: Development and implementation of structured care programmes with a more holistic approach, can improve future ICD care. The content of the written educational materials need to be more holistic, rather than mainly focusing on the biophysical and technical aspects of living with an ICD.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Nyckelord

Implantable Cardioverter Defibrillator

care

nursing

organisation

follow-up

patient education

MEDICINE

MEDICIN

Nursing

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