Systematic ReviewResearchPatient EducationWorkflow

mHealth-supported remote cardiac rehabilitation improved exercise capacity in heart failure, with limited certainty

JMIR mHealth and uHealth (PubMed)Jul 21, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A meta-analysis of eight randomized trials involving 1,368 patients with heart failure found that structured remote, virtual, or hybrid cardiac rehabilitation supported by mobile health improved selected exercise-capacity outcomes versus usual or center-based care, but evidence certainty was low to moderate.

What NurseJet pulled from the source

The review compared exercise-focused mobile health cardiac rehabilitation with usual care or center-based rehabilitation. Against usual care, remote, virtual, or hybrid programs improved six-minute walk distance by a pooled mean of 22.99 meters. Against center-based rehabilitation, peak oxygen uptake improved by 0.82 mL/kg/min, although this estimate came from few trials. No intervention-related deaths or serious adverse events were reported, but sparse events and short follow-up prevented firm safety conclusions or a claim that remote programs are equivalent or superior to center-based care.

Why this matters for nurses

Cardiology and medical-surgical nurses help assess readiness for activity, reinforce heart-failure self-management, coordinate discharge referrals, and identify symptoms that require escalation. The review suggests that structured mobile health delivery can extend rehabilitation access while underscoring that it is not interchangeable with every center-based program.

Bedside takeaway

Mobile health-supported cardiac rehabilitation improved selected exercise measures, but programs still require individualized referral, monitoring, and escalation plans.

How This Applies in Practice

Use this when: Preparing or following up with a patient with heart failure who has been referred to a structured remote, virtual, or hybrid cardiac rehabilitation program.

On your shift

Confirm the rehabilitation referral, prescribed activity parameters, monitoring plan, and the patient's ability to use the required technology.
Reinforce the program's symptom, weight, and activity tracking instructions and verify that the patient knows whom to contact for concerning changes.
Escalate worsening dyspnea, edema, dizziness, chest symptoms, or reduced exercise tolerance through the heart-failure team.

Keep in mind: Do not substitute a consumer exercise app for a clinician-directed rehabilitation plan or infer equivalence to center-based care. Follow the cardiac rehabilitation protocol, facility policy, and patient-specific provider orders.

Explain this for my unit

Key takeaways

Eight randomized trials with 1,368 participants evaluated structured mobile health-supported cardiac rehabilitation.
Compared with usual care, six-minute walk distance improved by a pooled mean of 22.99 meters.
Peak oxygen uptake improved modestly versus center-based rehabilitation, but the comparison included few trials.
Evidence certainty was low to moderate, and sparse safety events and short follow-up limited safety conclusions.

Practice implications

Confirm that a remote rehabilitation plan is clinician-directed and matches the patient's functional status, technology access, and monitoring needs. Reinforce prescribed symptom and activity tracking, review escalation instructions, and communicate worsening dyspnea, edema, dizziness, chest symptoms, or exercise intolerance through the heart-failure team.

Limitations & cautions

Only eight trials were included, comparator types and program designs differed, and some estimates came from single studies or few trials. Evidence certainty ranged from low to moderate, follow-up was generally short, and sparse adverse events do not establish long-term safety, equivalence, or noninferiority to center-based rehabilitation.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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JMIR mHealth and uHealth (PubMed)

JMIR mHealth and uHealth (PubMed). Effects of Remote, Virtual, or Hybrid Cardiac Rehabilitation Supported by mHealth in Patients With Heart Failure: Systematic Review and Meta-Analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42480049/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Nursing open (PubMed)Jul 1, 2026Research ArticlePractice applicable

A randomized trial of 170 adults scheduled for intestinal stoma surgery found that adding practice with a wearable stoma-care training belt to standard preoperative education improved self-care skills, adjustment, anxiety, and education satisfaction through 30 days after discharge.

Med-SurgAI summaryReview source

Research ArticleResearchPatient EducationWorkflowPractice applicableAI summary · original source linked below

Patients at two university hospitals were randomized to standard care alone or standard care plus preoperative belt-based practice. The intervention group had higher stoma-care skill and adjustment scores at every postoperative assessment, lower anxiety from discharge through day 30, and higher satisfaction at the preoperative and discharge assessments. The study evaluated short-term patient-reported and skill outcomes rather than complications or readmissions.

Key takeaways

The trial randomized 170 patients preparing for intestinal stoma surgery at two university hospitals.
The training belt allowed preoperative practice without applying an adhesive system directly to the abdomen.
Skill and adjustment scores favored belt-based practice at discharge and through 30 days after discharge.
The abstract does not establish effects on stoma complications, healthcare use, or outcomes beyond the first postoperative month.

Why this matters on shift

Wound and ostomy nurses help patients build confidence with equipment before they must manage a new stoma at home. The trial supports hands-on rehearsal as an addition to the established teaching pathway while keeping the evidence focused on early skills, adjustment, anxiety, and satisfaction.

Bedside takeaway

Hands-on preoperative stoma practice improved early skills and adjustment, but clinical and longer-term outcomes were not measured.

Nursing implications

When an approved simulation device is available, integrate supervised practice into the existing preoperative stoma-education plan. Observe the patient's technique, revisit difficult steps before discharge, and arrange follow-up for ongoing skill or adjustment concerns.

Limitations & cautions

The trial was conducted in general-surgery departments at two university hospitals and followed patients for 30 days after discharge. The abstract does not report blinding, clinical complications, readmissions, long-term self-management, or whether the findings generalize to other devices, stoma types, or care settings.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Nursing open (PubMed). Effect of a Stoma Care Training Belt on Stoma Care Skills, Adjustment, Anxiety and Satisfaction in Intestinal Stoma Patients: Randomized Controlled Study.

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Critical care nursing clinics of North America (PubMed)Jun 22, 2026Systematic ReviewPractice applicable

A clinical review describes ICU nurses as central to coordinated prevention of multidrug-resistant organism transmission through stewardship, pathogen surveillance, appropriate isolation precautions, and evidence-based hygiene practices.

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The review links ICU vulnerability to immunosuppression, invasive devices, broad-spectrum antimicrobial exposure, and the care environment. It emphasizes a multimodal, team-based approach rather than a single intervention, including laboratory and antibiotic stewardship, passive and active surveillance, timely use and de-escalation of precautions, and hygiene measures. The abstract does not report a systematic search or pooled patient outcomes.

Key takeaways

Critically ill patients face overlapping exposure risks related to devices, antimicrobials, immune dysfunction, and the ICU environment.
The review frames MDRO prevention as coordinated work across bedside nursing, infection prevention, laboratory, and antimicrobial-stewardship teams.
Nursing responsibilities include surveillance, hygiene, and correct implementation and de-escalation of ordered precautions.
This is a clinical review, so it does not quantify the independent effect of any single prevention measure.

Why this matters on shift

ICU nurses are continuously positioned to recognize new transmission risks, maintain device and hygiene practices, and identify when precaution or antimicrobial plans need clarification. The review supports reliable team coordination while leaving organism-specific actions to current infection-prevention guidance.

Bedside takeaway

MDRO prevention in the ICU depends on coordinated surveillance, precautions, stewardship, hygiene, and reliable bedside execution.

Nursing implications

Verify the organism-specific precaution plan at handoff, perform the approved hygiene and device-care bundle, and communicate changes in cultures, antimicrobial therapy, or isolation status. Escalate uncertainty promptly to infection prevention and the treating team.

Limitations & cautions

The PubMed abstract describes a narrative clinical review without a reported systematic search, evidence grading, sample, or pooled effect estimates. It does not establish the comparative effectiveness of specific surveillance, isolation, stewardship, or hygiene interventions, and local resistance patterns may change implementation.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

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Across 11 meta-analyses and two narrative syntheses, digital interventions were associated with improvements in physical activity, quality of life, lung function, adherence, anxiety, and depression. Results were inconclusive for dyspnea, physical capacity, sedentary time, emergency visits, and mortality. Differences among programs, populations, outcomes, and review methods limit confidence in applying one pooled estimate to a specific tool.

Key takeaways

The umbrella review included 13 systematic reviews representing 15,363 participants with COPD.
Pooled findings favored digital self-management for physical activity, quality of life, lung function, adherence, anxiety, and depression.
Effects on dyspnea, physical capacity, sedentary time, emergency visits, and mortality were inconclusive.
Substantial heterogeneity and very low-to-moderate evidence certainty limit claims about a best platform or long-term clinical benefit.

Why this matters on shift

Medical-surgical nurses reinforce COPD self-management before discharge and help identify whether patients can use a digital plan safely after leaving the hospital. The review suggests digital support can extend education and follow-up, but it does not replace individualized assessment or establish fewer emergency visits or deaths.

Bedside takeaway

Digital COPD support may improve several self-management outcomes, but platform choice and escalation still require individualized clinical oversight.

Nursing implications

Confirm that the digital program is part of the clinical care plan and that the patient can access and understand it. Reinforce how to record symptoms, use the program's escalation pathway, and seek direct assessment when symptoms worsen rather than relying on the platform alone.

Limitations & cautions

This umbrella review synthesized existing reviews rather than individual trials. Interventions, comparators, populations, outcome definitions, and follow-up periods varied; heterogeneity was substantial for most outcomes; and GRADE certainty ranged from very low to moderate. The evidence was inconclusive for emergency visits and mortality.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pulmonology (PubMed). Effectiveness of self-management digital interventions in improving health-related outcomes in patients with chronic obstructive pulmonary disease: An umbrella review.

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Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

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