International Journal of Nursing & Clinical Practices Volume 1 (2014), Article ID 1:IJNCP-107, 5 pages
Research Article
The Direct Program: A Disease/Inflammatory vs Risk Factor Evaluation Cardiovascular Testing Program

Amy L Doneen

Heart Attack & Stroke Prevention Center, Washington, USA
Amy L Doneen, Heart Attack & Stroke Prevention Center, 507 S. Washington #170, Spokane, WA 99204, USA, Tel: (509) 747-8000, Fax: (509) 747-8051; E-mail:
15 November 2014; 22 December 2014; 24 December 2014
Doneen AL (2014) The Direct Program: A Disease/Inflammatory vs Risk Factor Evaluation Cardiovascular Testing Program. Int J Nurs Clin Pract 1: 107. doi:


The DIRECT Program-Disease/Inflammation vs Risk Evaluation Cardiovascular Testing Program (DIRECT) is a continuing education program developed and delivered to nurse practitioners that addresses the gap in practice between a risk factor approach to cardiovascular assessment and the scientific evidence for a disease/inflammatory approach. The purpose of this article is to describe the DIRECT program, identify the gaps in current guidelines and then describe the process by which the DIRECT program was tested with a group of practicing nurse practitioners.

The activity was created after a systemic review of the current clinical guidelines for cardiovascular disease risk assessment presented a comprehensive review of the evidence supporting a disease/inflammatory approach to cardiovascular disease prevention. Following the delivery of the course content, the nurse practitioners were given ample time to discuss the information and they were evaluated for course knowledge and queried about intent to apply the information to practice. Clinical decision making of nurse practitioners completing this activity was assessed using clinical case application of both models (disease and risk). The aim of this program was to promote a health-screening model for family practice nurse practitioners with the goal of preventing heart attacks and ischemic strokes in primary care patients, aimed at quality improvement of care and the application of a new care model for nursing practice. This program celebrates the core foundational calling for doctoral prepared nurses to practice the most advanced level of nursing practice, which involves the application of current scientific knowledge that transcends specialties for the benefit of optimal health for the patient. The results revealed a statistically significant indication that the nurse practitioners felt that DIRECT would enhance their current practice and they felt a disease/inflammatory approach to cardiovascular disease risk assessment was more effective than the standard risk factor model currently in the standard of care.