Profile of atrial fibrillation inpatients: Cardiovascular risk factors and cardiac rehabilitation programme delivery and referral patterns

Atrial fibrillation (AF) is increasingly common; however, the cardiovascular risk factor profile and the patterns of delivery and referral to cardiac rehabilitation (CR) in this population are poorly described. We conducted an audit of medical records (n = 145) of patients admitted with AF in one local health district in Sydney, Australia. Patients were aged a mean 72 years, and 51% were male. Lack of risk factor documentation was common. Despite this, 65% had two or more modifiable cardiovascular risk factors, including hypertension (63%) and hypercholesterolaemia (52%). Referral to Phase II CR occurred for 25% and was decreased with permanent AF diagnosis and increased with more risk factors. AF patients admitted to hospital have multiple cardiovascular risk factors but limited risk factor screening and/or referral to outpatient CR programmes.     

‘Why nurses are leaving the profession … lack of support from managers’: What nurses from an e‐cohort study said

The shortage of nurses is known. We explored nurses' reasons for leaving the profession based on responses from an e‐newsletter of the Nurses and Midwives e‐cohort Study. Qualitative content analysis of data from email responses (n = 66) showed ‘Lack of support’ as a social work value describing their manager's lack of support, unsupportive relationships within their work group, and a health‐care system putting business principles before care resulting in job dissatisfaction and nurse turnover. These findings are examples of a ‘complex'/‘wicked’ problem and as such will resist simple solutions to the presenting issues. The dialogic process such as Open Space Technology and Talking Circles should be considered as potentially suitable to the needs of nurses.