Heart, Lung and Circulation

The Development of a New Cardiac Rehabilitation Needs Assessment Tool (CRNAT) for Individualised Secondary Prevention

  • Julie Smith
    National Heart Foundation, Subiaco, Western Australia, 6008

    Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001

    Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, 6000
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  • Jacquie Garton-Smith
    Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001

    Clinical Services, Royal Perth Hospital, Perth, Western Australia, 6000

    Bentley Armadale Medicare Local, Bentley, Western Australia, 6102
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  • Tom Briffa
    Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001

    Cardiovascular Research Group, School of Population Health, The University of Western Australia, Nedlands, 6009
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  • Andrew Maiorana
    Corresponding author at: School of Physiotherapy and Exercise Science, Curtin University, Kent St, Bentley, Western Australia, 6102. Tel.: +61 8 9266 4644; fax: +61 8 9266 2605.
    Cardiovascular Health Network, Department of Health, East Perth, Western Australia, 6001

    Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, Western Australia, 6000

    School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, 6102
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Published:January 20, 2015DOI:


      Cardiac rehabilitation and secondary prevention are evidence-based strategies to reduce the risk of recurrent cardiac events but are underutilised. New approaches are required to improve uptake.


      A new cardiac rehabilitation needs assessment tool (CRNAT), for use by cardiology ward nurses, was developed and refined in collaboration with stakeholders through action research. The tool documented patients’ risk factors, initiated a discussion about secondary prevention and linked patients to post-discharge follow-up. The initial version of the tool was developed through consultation with cardiac rehabilitation specialist staff (n=3), reviewed by ward nurses (n=4) and general practitioners (GP) (n=8), and piloted in patients (n=8). Review was undertaken at six months post implementation through patient (n=66) and GP (n=10) surveys, with additional patient feedback through focus groups (n=8 patients) and phone interviews (n=14). At 12 months, ward nurses (n=21) were surveyed.


      The CRNAT was well regarded by patients and GPs and stakeholder feedback resulted in only minor changes to the tool's content. Feedback from ward nurses led to important changes to the process of administering the tool to streamline its use in an inpatient setting.


      Feedback from end users is important when developing a new clinical tool to ensure it meets their requirements.


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