Nurse Practitioner Use of Sublingual Nitroglycerin in Stable Ischemic Heart Disease

Abstract

Abstract Problem Statement: Coronary artery disease is a leading cause of death in the United States. Millions of Americans have some form of cardiovascular disease, including angina. Angina affects quality of life. Sublingual nitroglycerin (SLNTG) is a mainstay of therapy for the self-management of angina. Literature suggests a discordance exists between guideline recommendations and SLNTG prescribing practices. Purpose: To identify knowledge, barriers, and current practice of Nurse Practitioners (NPs) in primary care and specialty clinics in North Carolina (NC) in the use of SLNTG in the stable ischemic heart disease (SIHD) patient. Questions: (1) Do NPs in NC practicing in primary care and specialty clinics report an understanding of the use of SLNTG for the self-management of angina? (2) Do NPs report an understanding of contraindications for the use of SLNTG? (3) Does the understanding and utilization of SLNTG in the SIHD patient differ among practice specialties (such as primary care compared to cardiology)? Methods: This Doctor of Nursing Practice project was a non-experimental, cross-sectional, quantitative project using a descriptive survey administered via electronic-mail to a convenience sample of 2236 NPs in NC. Analysis: Frequency distribution was used to score the respondents correct responses. Understanding and utilization of SLNTG among practice specialties was assessed with Chi-square for independence. Significance: Nurse practitioner respondents were less knowledgeable about SLNTG as premedication for effort-induced angina; but were aware of correct dosing of SLNTG, use of SLNTG with phosphodiesterase inhibitors and when to replace SLNTG. Keywords: nitroglycerin, guidelines, nurse practitioner, stable ischemic heart disease