[Nurse practitioner equally as good as a resident in the treatment of stable patients after recent myocardial infarction, but with more patient satisfaction].

OBJECTIVE

To determine the feasibility and efficacy ofa nurse-led clinic for stable patients recovering from a recent myocardial infarction, as opposed to a resident-led clinic.

DESIGN

Randomized study.

METHOD

Over a period of 1 year, data on the treatment and complications of 200 consecutive infarction patients were collected. The patients were randomized on transfer from the coronary-care unit to the cardiology ward. Subsequently, these patients were treated by a registered nurse practitioner (n = 97) or by a resident (n = 103), both of whom were under the direct supervision of the attending cardiologist. Degree of satisfaction was scored by the patients on a 0-10 point scale.

RESULTS

The patients in both groups were predominantly men (75%) with a mean age of 63 years. Risk factors and cardiac histories were comparable in both groups as were the location of the infarction and the nature of the acute treatment. No significant differences between the groups were found in the main endpoints: mortality (0%), re-infarctions (2%) or length ofstay. However, patients treated by the nurse practitioner expressed a significantly higher score in the satisfaction study.

CONCLUSION

The treatment of stable postmyocardial infarction patients in a nurse-practitioner-led clinic post was found to be feasible and effective with a significantly higher level of patient satisfaction.