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Margaret Therese Bowers

Clinical Professor in the School of Nursing
School of Nursing
Box 3322 Med Ctr, Durham, NC 27710
School of Nursing, Room 2033, Durham, NC 27710
Office hours Available by appointment  

Selected Publications


Incidence and predictors of post-thrombotic syndrome in patients with proximal DVT in a real-world setting: findings from the GARFIELD-VTE registry.

Journal Article Journal of thrombosis and thrombolysis · February 2024 Although substantial progress has been made in the pathophysiology and management of the post-thrombotic syndrome (PTS), several aspects still need clarification. Among them, the incidence and severity of PTS in the real world, the risk factors for its dev ... Full text Cite

Role of Advanced Practice Providers in the Cardiac Intensive Care Unit Team.

Journal Article Journal of the American College of Cardiology · December 2023 Full text Cite

An interprofessional initiative to improve the “drop to shock” interval on a college campus

Journal Article Teaching and Learning in Nursing · October 1, 2023 This project engaged healthcare students in an interprofessional (IP) activity to design a program to increase awareness of automated external defibrillators device locations on campus. A Plan-Do-Study-Act approach was used. We highlight how an IP activity ... Full text Cite

Heart Failure: Priorities for Transition to Home.

Journal Article The Nursing clinics of North America · September 2023 Nurses play a key role in promoting successful transitions of patients with heart failure (HF) from the hospital to the ambulatory setting. Engaging patients and caregivers in discharge teaching early in the hospitalization can enhance their understanding ... Full text Cite

Early Intervention for Steal Syndrome in Patients on Hemodialysis.

Journal Article Nephrology nursing journal : journal of the American Nephrology Nurses' Association · March 2023 Dialysis access-associated steal syndrome (DASS) is a serious, challenging complication related to diminished arterial blood flow to the hand. Patients may not be routinely assessed for this diagnosis, resulting in a delayed presentation with severe hand p ... Cite

Effective interprofessional precepting in a specialty clinic: Utilizing evidence and lived experiences to optimize the training of diverse learners

Journal Article Journal of Interprofessional Education and Practice · March 1, 2022 Preceptors often train students from different educational backgrounds. Many preceptors do not have adequate preparation to assess and educate students from backgrounds that differ from their own. Training students in specialty clinics creates additional c ... Full text Cite

Early Identification of Patients at Risk for Incident Heart Failure With Preserved Ejection Fraction: Novel Approach to Echocardiographic Trends.

Journal Article J Card Fail · September 2021 BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) continues to increase in prevalence with a 50% mortality rate within 3 years of diagnosis, but lacking effective evidence-based therapies. Specific echocardiographic markers are not typical ... Full text Link to item Cite

Embracing Disruption: Measuring Effectiveness of Virtual Simulations in Advanced Practice Nurse Curriculum.

Journal Article Clinical simulation in nursing · August 2021 Changes in academia have occurred quickly in response to the COVID-19 pandemic. In-person simulation-based education has been adapted into a virtual format to meet course learning objectives. The methods and procedures leveraged to onboard faculty, staff, ... Full text Cite

Preoperative Home-Based Exercises to Decrease Postoperative Complications: A Clinical Practice Innovation

Journal Article Journal for Nurse Practitioners · June 1, 2021 Cardiac surgery is associated with postoperative pulmonary complications that increase length of stay (LOS). The literature supports the use of preoperative exercise therapy to improve postoperative outcomes. This practice innovation implemented a home-bas ... Full text Cite

A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit.

Journal Article Critical care nurse · April 2021 BackgroundCatheter-associated urinary tract infections are the second most common health care-associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs.L ... Full text Cite

Shared medical appointments: Translating research into practice for patients treated with ablation therapy for atrial fibrillation.

Journal Article PloS one · January 2021 BackgroundPeople with atrial fibrillation (AF) have lower reported quality of life and increased risk of heart attack, death, and stroke. Lifestyle modifications can improve arrhythmia-free survival/symptom severity. Shared medical appointments (S ... Full text Cite

Impact of a Palliative Care Education Module in Patients With Heart Failure.

Journal Article Am J Hosp Palliat Care · December 2020 BACKGROUND: Heart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recommend the ... Full text Link to item Cite

Implementation of a Disease Management Program in Adult Patients With Heart Failure.

Journal Article Professional case management · November 2020 BackgroundApproximately 5.7 million people in the United States are diagnosed and living with heart failure (HF), with projected prevalence rates to increase 46% by 2030. Heart failure leads hospital admissions in the United States for individuals ... Full text Cite

Benefits of Optimizing Heart Failure Medication Dosage

Journal Article Journal for Nurse Practitioners · July 1, 2020 Heart failure is the leading cause of hospitalizations and readmissions. Guideline-directed medical therapy is the cornerstone to improving outcomes, but less than 20% of patients with heart failure marked by reduced ejection fraction receive target doses. ... Full text Cite

Supporting the Advanced Practice Registered Nurse (APRN) Student and Faculty/Instructors

Chapter · December 28, 2019 This book provides a method and foundation to transform graduate nursing education to competency-based clinical evaluation, empowering programs with standardized templates and interprofessional education options for each case to advance ... ... Cite

Adult Heart Faillure

Chapter · December 28, 2019 This book provides a method and foundation to transform graduate nursing education to competency-based clinical evaluation, empowering programs with standardized templates and interprofessional education options for each case to advance ... ... Cite

Implementation of home-based international normalized ratio testing in adult patients treated with warfarin.

Journal Article Journal of the American Association of Nurse Practitioners · November 2019 Background and local problemPatients who take warfarin require frequent testing of their international normalized ratio (INR) level to ensure accurate dosage. Frequent testing can be inconvenient for patients in rural settings, the workforce, the ... Full text Cite

AANP Forum

Journal Article The Journal for Nurse Practitioners · February 2019 Full text Cite

Chronic Heart Failure: Impact of the Current Guidelines

Journal Article Journal for Nurse Practitioners · January 1, 2019 Despite the persistent high mortality, many adults are living with chronic heart failure. Recent updates to the clinical guidelines for managing heart failure provide substantive recommendations on how to treat patients with heart failure with preserved ej ... Full text Cite

Access to opportunity: The duke-east Carolina partnerships for training program

Journal Article Online Learning Journal · January 1, 2019 Duke University and East Carolina University through their Schools of Nursing and Physician Assistant Programs are in the third year of the Partnerships for Training Program (PFT). The goal of PFT is to prepare primary care providers to increase access to ... Full text Cite

Incidence and predictors of post-thrombotic syndrome in patients with proximal DVT in a real-world setting: findings from the GARFIELD-VTE registry.

Journal Article Journal of thrombosis and thrombolysis · February 2024 Although substantial progress has been made in the pathophysiology and management of the post-thrombotic syndrome (PTS), several aspects still need clarification. Among them, the incidence and severity of PTS in the real world, the risk factors for its dev ... Full text Cite

Role of Advanced Practice Providers in the Cardiac Intensive Care Unit Team.

Journal Article Journal of the American College of Cardiology · December 2023 Full text Cite

An interprofessional initiative to improve the “drop to shock” interval on a college campus

Journal Article Teaching and Learning in Nursing · October 1, 2023 This project engaged healthcare students in an interprofessional (IP) activity to design a program to increase awareness of automated external defibrillators device locations on campus. A Plan-Do-Study-Act approach was used. We highlight how an IP activity ... Full text Cite

Heart Failure: Priorities for Transition to Home.

Journal Article The Nursing clinics of North America · September 2023 Nurses play a key role in promoting successful transitions of patients with heart failure (HF) from the hospital to the ambulatory setting. Engaging patients and caregivers in discharge teaching early in the hospitalization can enhance their understanding ... Full text Cite

Early Intervention for Steal Syndrome in Patients on Hemodialysis.

Journal Article Nephrology nursing journal : journal of the American Nephrology Nurses' Association · March 2023 Dialysis access-associated steal syndrome (DASS) is a serious, challenging complication related to diminished arterial blood flow to the hand. Patients may not be routinely assessed for this diagnosis, resulting in a delayed presentation with severe hand p ... Cite

Effective interprofessional precepting in a specialty clinic: Utilizing evidence and lived experiences to optimize the training of diverse learners

Journal Article Journal of Interprofessional Education and Practice · March 1, 2022 Preceptors often train students from different educational backgrounds. Many preceptors do not have adequate preparation to assess and educate students from backgrounds that differ from their own. Training students in specialty clinics creates additional c ... Full text Cite

Early Identification of Patients at Risk for Incident Heart Failure With Preserved Ejection Fraction: Novel Approach to Echocardiographic Trends.

Journal Article J Card Fail · September 2021 BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) continues to increase in prevalence with a 50% mortality rate within 3 years of diagnosis, but lacking effective evidence-based therapies. Specific echocardiographic markers are not typical ... Full text Link to item Cite

Embracing Disruption: Measuring Effectiveness of Virtual Simulations in Advanced Practice Nurse Curriculum.

Journal Article Clinical simulation in nursing · August 2021 Changes in academia have occurred quickly in response to the COVID-19 pandemic. In-person simulation-based education has been adapted into a virtual format to meet course learning objectives. The methods and procedures leveraged to onboard faculty, staff, ... Full text Cite

Preoperative Home-Based Exercises to Decrease Postoperative Complications: A Clinical Practice Innovation

Journal Article Journal for Nurse Practitioners · June 1, 2021 Cardiac surgery is associated with postoperative pulmonary complications that increase length of stay (LOS). The literature supports the use of preoperative exercise therapy to improve postoperative outcomes. This practice innovation implemented a home-bas ... Full text Cite

A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit.

Journal Article Critical care nurse · April 2021 BackgroundCatheter-associated urinary tract infections are the second most common health care-associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs.L ... Full text Cite

Shared medical appointments: Translating research into practice for patients treated with ablation therapy for atrial fibrillation.

Journal Article PloS one · January 2021 BackgroundPeople with atrial fibrillation (AF) have lower reported quality of life and increased risk of heart attack, death, and stroke. Lifestyle modifications can improve arrhythmia-free survival/symptom severity. Shared medical appointments (S ... Full text Cite

Impact of a Palliative Care Education Module in Patients With Heart Failure.

Journal Article Am J Hosp Palliat Care · December 2020 BACKGROUND: Heart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recommend the ... Full text Link to item Cite

Implementation of a Disease Management Program in Adult Patients With Heart Failure.

Journal Article Professional case management · November 2020 BackgroundApproximately 5.7 million people in the United States are diagnosed and living with heart failure (HF), with projected prevalence rates to increase 46% by 2030. Heart failure leads hospital admissions in the United States for individuals ... Full text Cite

Benefits of Optimizing Heart Failure Medication Dosage

Journal Article Journal for Nurse Practitioners · July 1, 2020 Heart failure is the leading cause of hospitalizations and readmissions. Guideline-directed medical therapy is the cornerstone to improving outcomes, but less than 20% of patients with heart failure marked by reduced ejection fraction receive target doses. ... Full text Cite

Supporting the Advanced Practice Registered Nurse (APRN) Student and Faculty/Instructors

Chapter · December 28, 2019 This book provides a method and foundation to transform graduate nursing education to competency-based clinical evaluation, empowering programs with standardized templates and interprofessional education options for each case to advance ... ... Cite

Adult Heart Faillure

Chapter · December 28, 2019 This book provides a method and foundation to transform graduate nursing education to competency-based clinical evaluation, empowering programs with standardized templates and interprofessional education options for each case to advance ... ... Cite

Implementation of home-based international normalized ratio testing in adult patients treated with warfarin.

Journal Article Journal of the American Association of Nurse Practitioners · November 2019 Background and local problemPatients who take warfarin require frequent testing of their international normalized ratio (INR) level to ensure accurate dosage. Frequent testing can be inconvenient for patients in rural settings, the workforce, the ... Full text Cite

AANP Forum

Journal Article The Journal for Nurse Practitioners · February 2019 Full text Cite

Chronic Heart Failure: Impact of the Current Guidelines

Journal Article Journal for Nurse Practitioners · January 1, 2019 Despite the persistent high mortality, many adults are living with chronic heart failure. Recent updates to the clinical guidelines for managing heart failure provide substantive recommendations on how to treat patients with heart failure with preserved ej ... Full text Cite

Access to opportunity: The duke-east Carolina partnerships for training program

Journal Article Online Learning Journal · January 1, 2019 Duke University and East Carolina University through their Schools of Nursing and Physician Assistant Programs are in the third year of the Partnerships for Training Program (PFT). The goal of PFT is to prepare primary care providers to increase access to ... Full text Cite

Making Sense of Hypertension Guidelines.

Journal Article The Journal of cardiovascular nursing · September 2018 Hypertension is a leading risk factor for heart disease, stroke, kidney failure, and diabetes and is a predisposing risk factor for most cardiovascular chronic illnesses. The risk for major cardiovascular events drops significantly when guideline-based blo ... Full text Cite

The Digital Drag and Drop Pillbox: Design and Feasibility of a Skill-based Education Model to Improve Medication Management.

Journal Article J Cardiovasc Nurs · 2017 OBJECTIVE: We present the design and feasibility testing for the "Digital Drag and Drop Pillbox" (D-3 Pillbox), a skill-based educational approach that engages patients and providers, measures performance, and generates reports of medication management ski ... Full text Open Access Link to item Cite

Cardiovascular Disease and HIV: Pathophysiology, Treatment Considerations, and Nursing Implications.

Journal Article Crit Care Nurse · October 2016 HIV infection has progressed from an acute, terminal disease to a chronic illness with cardiovascular disease as the leading cause of death among persons living with HIV. As persons living with HIV infection continue to become older, traditional risk facto ... Full text Link to item Cite

Current Challenges in Complex Health Care Organizations: The Triple Aim

Chapter · September 28, 2016 Motivation: Leading by Inspiration and Modeling ... Cite

Implementing Electronic Tablet-Based Education of Acute Care Patients.

Journal Article Crit Care Nurse · February 2016 Poor education-related discharge preparedness for patients with heart failure is believed to be a major cause of avoidable rehospitalizations. Technology-based applications offer innovative educational approaches that may improve educational readiness for ... Full text Link to item Cite

Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

Journal Article Am Heart J · November 2015 BACKGROUND: Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes wou ... Full text Link to item Cite

Integrating Mental Health Concepts in the Care of Adults With Chronic Illnesses: A Curricular Enhancement.

Journal Article The Journal of nursing education · November 2015 BackgroundIn the United States, inadequate attention has been given to the mental health needs of chronically ill adults, and the attempts to integrate mental health in primary care have fallen short.MethodThis article describes the begin ... Full text Cite

Cardiovascular Health Among an Underserved Population: Clinical Implications.

Journal Article The Nursing clinics of North America · September 2015 Despite general efforts to reduce risk factors in cardiovascular disease in the United States over the previous decade, disparities in cardiovascular care remain more prevalent in the underserved population. Recent focus has shifted from treatment of disea ... Full text Cite

Improving Congestive Heart Failure Care with a Clinical Decision Unit.

Journal Article Nursing economic$ · September 2015 Evidence supporting the development of Clinical Decision Units (CDUs) to impact congestive heart failure readmission rates comes from several categories of the literature. In this study, a pre-post design with comparison group was used to evaluate the impa ... Cite

Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients.

Journal Article Am Heart J · April 2015 BACKGROUND: Poor adherence to evidence-based medications in heart failure (HF) is a major cause of avoidable hospitalizations, disability, and death. To test the feasibility of improving medication adherence, we performed a randomized proof-of-concept stud ... Full text Open Access Link to item Cite

Results of the chronic heart failure intervention to improve medication adherence study: A randomized intervention in high-risk patients

Journal Article American Heart Journal · April 1, 2015 Background Poor adherence to evidence-based medications in heart failure (HF) is a major cause of avoidable hospitalizations, disability, and death. To test the feasibility of improving medication adherence, we performed a randomized proof-of-concept study ... Full text Open Access Cite

Setting up systems of care

Chapter · June 14, 2014 The information in this book is based on the Heart Failure Disease Management workshop that has been presented by the American Association of Heart Failure Nurses. ... Cite

Managing Patients With Heart Failure

Journal Article Journal for Nurse Practitioners · January 1, 2013 Adults with chronic heart failure (HF) are living longer. Thus, management of symptom exacerbation related to this chronic illness is paramount to improving quality of life and reducing hospitalizations. This article provides key recommendations for nurse ... Full text Cite

Introduction of the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Costing Tool: a user-friendly spreadsheet program to estimate costs of providing patient-centered interventions.

Journal Article Circ Cardiovasc Qual Outcomes · January 2012 BACKGROUND: Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions ... Full text Link to item Cite

Got the picture? Using mobile phone technology to reinforce discharge instructions.

Journal Article The American journal of nursing · August 2011 Full text Cite

The STARBRITE trial: a randomized, pilot study of B-type natriuretic peptide-guided therapy in patients with advanced heart failure.

Journal Article J Card Fail · August 2011 BACKGROUND: STARBRITE, a multicenter randomized pilot trial, tested whether outpatient diuretic management guided by B-type natriuretic peptide (BNP) and clinical assessment resulted in more days alive and not hospitalized over 90 days compared with clinic ... Full text Link to item Cite

Coping effectively with heart failure (COPE-HF): design and rationale of a telephone-based coping skills intervention.

Journal Article J Card Fail · March 2011 BACKGROUND: Coping Effectively with Heart Failure (COPE-HF) is an ongoing randomized clinical trial funded by the National Institutes of Health to evaluate if a coping skills training (CST) intervention will result in improved health status and quality of ... Full text Link to item Cite

Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure.

Journal Article J Am Coll Cardiol · January 25, 2011 OBJECTIVES: The purpose of this study was to assess the impact of changes in symptoms of depression over a 1-year period on subsequent clinical outcomes in heart failure (HF) patients. BACKGROUND: Emerging evidence shows that clinical depression, which is ... Full text Link to item Cite

Acute and Primary Care Advanced Practice Nursing: Past, Present, and Future

Chapter · 2011 The 3rd edition of this AJN Book-of-the-Year Award winner prepares graduate nurses to meet the challenges of practice today and to take leadership roles in the future. ... Cite

Lost in translation: Engaging nurses in research at the point of care

Conference Heart and Lung: the journal of acute and critical care · 2010 Cite

Is shock a key element in the pathology of sudden infant death syndrome (SIDS)?

Journal Article Biological research for nursing · October 2009 In developed countries, sudden infant death syndrome (SIDS) is the most common cause of death for infants between 1 month and 1 year of age. The etiology of SIDS is likely to be multifactorial, and current paradigms often describe three overlapping element ... Full text Cite

Discordance between patient-predicted and model-predicted life expectancy among ambulatory patients with heart failure.

Journal Article JAMA · June 4, 2008 CONTEXT: Patients with chronic heart failure have impaired long-term survival, but their own expectations regarding prognosis have not been well studied. OBJECTIVES: To quantify expectations for survival in patients with heart failure, to compare patient e ... Full text Link to item Cite

Delivering heart failure disease management in 3 tertiary care centers: key clinical components and venues of care.

Journal Article Am Heart J · April 2008 BACKGROUND: Little data exist to assist to help those organizing and managing heart failure (HF) disease management (DM) programs. We aimed to describe the intensity of outpatient HF care (clinic visits and telephone calls) and medical and nonpharmacologic ... Full text Link to item Cite

Diuretics and Nitrates

Chapter · 2004 Part of the Nursing Secrets Series, Cardiovascular Nursing Secrets is designed to be helpful for both new and experienced nurses in the cardiovascular field. ... Cite

Heart Failure

Chapter · 2004 Part of the Nursing Secrets Series, Cardiovascular Nursing Secrets is designed to be helpful for both new and experienced nurses in the cardiovascular field. ... Cite

Access to opportunity: The Duke-east Carolina partnerships for training program

Journal Article Journal of Asynchronous Learning Network · August 1, 2002 Duke University and East Carolina University through their Schools of Nursing and Physician Assistant Programs are in the third year of the Partnerships for Training Program (PFT). The goal of PFT is to prepare primary care providers to increase access to ... Cite

Current trends in the management of heart failure.

Journal Article The Nursing clinics of North America · December 2000 Heart failure will continue to present many challenges to health care providers. Research is ongoing to further understand the pathophysiology of this complex disease process. New therapies will be developed that hopefully will have a tremendous impact on ... Cite

Dog gone...excluding animals from clinical training

Conference Air Medical Journal · 1999 Cite

Competency based orientation: A tool for work redesign

Conference Air Medical Journal · 1995 Cite

Computerized documentation worksheet

Conference Air Medical Journal · 1995 Cite

Standards development for computerized medical charting

Conference Air Medical Journal · 1995 Cite

IABP logistics impactin air and ground transports

Conference Air Medical Journal · 1995 Cite

What is a resource nurse?

Conference Air Medical Journal Cite