nurse led clinics opportunity for nurses to make a difference wilma scholte op reimer, rn, phd...
TRANSCRIPT
![Page 1: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/1.jpg)
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
![Page 2: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/2.jpg)
Health Care Challenges
![Page 3: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/3.jpg)
Europe is ageing rapidly
![Page 4: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/4.jpg)
Proportion of 65+ years of age
5
10
15
20
1980 1985 1990 1995 2000 2005
0
10
15
20
% 65+
▬ European Region▬ EU-10
▬ European Union▬ EU-15
▬ CIS
║
1980 1985 1990 1995 2000 2005 2010
![Page 5: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/5.jpg)
159
141822273135404448535761667074798388
Age pyramid for Europe in 2008Age
Men Women
4 3 2 1 0 1 2 3 4
Numbers per million
90+
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
![Page 6: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/6.jpg)
159
141822273135404448535761667074798388
Age pyramid for Europe in 2050Age
Men Women
4 3 2 1 0 1 2 3 4
Numbers per million
90+
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
![Page 7: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/7.jpg)
↑ Age = ↑ Disease burden
![Page 8: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/8.jpg)
Major causes of death by age
0%
20%
40%
60%
80%
100%
Cardiovascular diseases Respiratory diseases Digestive disease
Cancer External causes of injury Other
0 10 20 30 40 50 60 70 80 ≥90 TotalAGE
![Page 9: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/9.jpg)
Increasing number of hospital discharges
![Page 10: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/10.jpg)
Hospital Discharge Cardiovascular Disease
1000
1500
2000
2500
3000
3500
1990 1995 2000 2005
No / 1,000 inhabitants
▬ European Region
▬ EU-10
▬ European Union
▬ EU-15
▬ CIS
0
25
35
20
30
15
║
1990 1995 2000 2005 2010
![Page 11: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/11.jpg)
Length of Hospital Stay
6
8
10
12
14
16
18
1985 1990 1995 2000 2005
Days
▬ European Region
▬ EU-10▬ European Union▬ EU-15
▬ CIS
0
12
18
10
16
8
║
14
1985 1990 1995 2000 2005 2010
![Page 12: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/12.jpg)
Older patients often suffer from comorbidity
![Page 13: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/13.jpg)
Underlying Heart Diseases in AFib
61
31 3025
70
41 40
29
0
20
40
60
80
Hypertension Heart failure CAD Valvular HD
≤ 75 years > 75 years
%%
![Page 14: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/14.jpg)
Number of underlying Heart Diseases
0%
20%
40%
60%
80%
100%
Age ≤ 75 Age > 75
4
3
2
1
0
![Page 15: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/15.jpg)
Increasing number of persons at risk
![Page 16: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/16.jpg)
Prevalence of Diabetes in Adults (Age 20-29)
0
2
4
6
8
10
12
Africa EasternMediterranean
and MiddleEast Region
Europe North America South &CentralAmerica
South-EastAsia
WesternPacific
2003 2025
%%
![Page 17: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/17.jpg)
0
20
40
60
80
100
EA-I EA-II ACS I CR AP DM ACS II PCI
%%
Improved Secondary Prevention since 1995
Antithrombotics
Lipid lowering
Beta-blockers
ACE-I/ARB
Surveys
1995 2005-2006
![Page 18: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/18.jpg)
EUROASPIRE SurveysPharmacological Treatment
89
86
75
93
63
66
49
84
32
54
31
81
0 20 40 60 80 100
Lipid lowering
Beta-blocker
ACE-I/ARB
Antiplatelet
1995-19962000-20012005-2006
%%
![Page 19: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/19.jpg)
EUROASPIRE SurveysLifestyle
29
55
38
18
60
54
33
21
87
55
25
20
0 20 40 60 80 100
Cholesterol > 5mmol/L
Blood pressure >140/90 mmHg
BMI > 30 kg/m2
Smoking
1995-19962000-20012005-2006
%%
![Page 20: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/20.jpg)
Also increasing number of caregivers ?
![Page 21: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/21.jpg)
10 to 146 to 10
2 to 33 to 6
14 to 19No 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
![Page 22: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/22.jpg)
Our Nurse Led ClinicSatellite Clinic of the Academic Hospital
![Page 23: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/23.jpg)
Borders
Patient care
Education
Research
![Page 24: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/24.jpg)
Crossing borders
Education
Research
Patient care
![Page 25: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/25.jpg)
Crossing borders
Education
Research
Patient care
![Page 26: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/26.jpg)
Evidence Based Care
![Page 27: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/27.jpg)
Multidisciplinary Care
![Page 28: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/28.jpg)
28
Why cardiovascular care?
![Page 29: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/29.jpg)
29
Why cardiovascular care?
• Expertise
• Complex & Multidisciplinary care
• High prevalence
• Facilities available
• Good financial possibilities
![Page 30: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/30.jpg)
![Page 31: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/31.jpg)
RESPONSE Trial: nurse led secondary prevention clinics
![Page 32: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/32.jpg)
RESPONSE Trial - Intervention
• 4 visits in 6 months
• Cardiovascular risk monitoring
• Care coordination
• Medical therapy
• Lifestyle counseling
• Adherence
• Screening diabetes
![Page 33: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/33.jpg)
RESPONSE Trial
![Page 34: Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical](https://reader035.vdocuments.net/reader035/viewer/2022070307/551ac2245503466b6a8b4d30/html5/thumbnails/34.jpg)
RESPONSE 2 TrialShared Decision Making