Managed care challenges and opportunities for cardiovascular advanced practice nurses

The aggressive changes in the health-care system are mandating revolutionary new approaches in patient-care delivery. Cardiovascular care, in particular, is under scrutiny due to its high cost and wide variation in outcome. The need to comprehensively coordinate cardiac surgical care and aggressively manage complex cases has resulted in growing interest in using cardiovascular advanced practice nurses (APNs) to ensure high-quality, yet cost-effective patient care. The unique skills of the cardiovascular APN as practitioner, consultant, educator, researcher, and change agent ensure optimal outcomes for patients and their families as well the staff, physicians, and the hospital's bottom line.