The Intermittent Claudication Research Study: vascular outcomes research using home health nurses

This article describes an ongoing, multicenter outcomes research study on intermittent claudication being conducted at 16 Chicago-area vascular surgery offices and clinics. The study relies on gathering data through a series of home health follow-up visits by visiting nurses who use portable Doppler equipment. A total of 624 patients (506 men and 118 women) have been enrolled to date. Data on study patients' baseline demographic characteristics, leg symptoms, peripheral blood flow, comorbidities, and walking impairments are presented. Initial physical functioning and walking-distance scores from patient self-report questionnaires are also presented, along with attrition and lower-extremity revascularization rates. The contribution of nursing to this type of patient outcomes research is discussed. The changing climate in health care delivery provides nursing with a great opportunity to influence the U.S. health care system. In particular, the participation of nurses can make a major contribution to research on patient outcomes and medical effectiveness, and especially to new methods of comparing treatment effects on patients' functional status. Interpretation and measurement of patient self-reported health status and quality of life are particularly relevant to nursing, which is based on interventions related to compromised function. Improvement of patients' physical functioning is the heart of nursing practice, and the focus of much of what is done in vascular medicine and surgery. This article describes the contribution of nursing skills and knowledge to an ongoing, government-funded, multicenter research study on intermittent claudication. The ability of nurses to make a unique contribution to outcomes research is demonstrated.