Senior Lecturer Kojiro Morita, PhD, MPH, RN, PHN in Department of Nursing Administration
This study examined whether certified nurses (CNs) specializing in heart failure (HF) are linked to better outcomes for hospitalized HF patients in Japan. Although these CNs are not legally recognized as advanced practice nurses (APNs), they have advanced clinical skills that are comparable to APN roles in other countries. Using a nationwide inpatient database of nearly one million patients, we found that hospitals with HF-certified nurses had slightly lower in-hospital mortality, even after adjusting for patient and hospital characteristics. However, there was no clear effect on 30-day readmission.
These findings suggest that specialized nurses can play an important role in improving the quality of HF care, particularly through better assessment, patient education, and teamwork with physicians. For Japan, the results highlight the value of investing in advanced nursing competencies within the current workforce. Internationally, this study provides insight for health systems that have limited APN roles, showing how specialized nursing support may contribute to better patient outcomes.
Access the full paper here: https://doi.org/10.1016/j.outlook.2025.102605