Download Cardiac Rehab Programs Can Improve Patient

What is role of cardiac rehabilitation in the outcome of patients who experience a major cardiac
event, within their first year of recovery?
Kimberly Akin, RN
State University of New York Institute of Technology
Department of Nursing
Abstract
A comprehensive cardiac rehabilitation program is highly beneficial for people who have experienced a cardiac event, such as a heart attack or bypass surgery. Cardiac rehabilitation can reduce the risk of death after cardiac event by 20-25% (Case Management Advisor). Cardiac
rehabilitation programs that include finding a lifetime activity for exercise as well as dietary and psychosocial counseling are dramatically effective in helping people make the lifestyle changes that will increase the likelihood of outliving their disease. Patients must understand that a
procedure, such as bypass surgery, and prescribed medications do not protect completely from the progression of the disease (Case Management Advisor).
Introduction
Cardiac Rehab Programs Can Improve Patient Health
 Highly Beneficial for people who have experienced a cardiac event, such
as heart attack, bypass surgery or PCI
 Can reduce the risk of death after a cardiac event by 20-25% (Case
Management Advisor)
 Programs are dramatically effective in helping people make the lifestyle
changes that will increase the likelihood of outliving their disease
 Cardiac Rehab Programs include finding a lifetime activity for exercise as
well as dietary and psychosocial counseling
 A new set of performance measures aimed at increasing patient enrollment
in cardiac rehab programs and setting standards of excellence for program
operation were released in 2007 by the American Association of
Cardiovascular and Pulmonary Rehabilitation; The American College of
Cardiology; and the American Heart Association (Consumer Reports on
Health)
 Requires a multi-disciplinary approach
 Performance measures pull all the pieces together to define a highperforming program that is providing all of the necessary services
 Patients must understand that a procedure, such as bypass surgery, and
prescribed medications do not protect completely from the progression of
the disease
 Patients are seen 2-3
times/week in a medical setting
for about 3 months
Patient Education
 An individualized exercise
prescription is developed for
each patient that is safe and
effective
 Patients Preform the exercise
prescription in a supervised
environment
 Patients need education on a
wide array of topics including
heart disease, medications used
to control symptoms, risk
factors, diet
related to heart healthy lifestyle, and the importance of cardiac rehab
 Once patients have information they must learn how to apply it to in order
to reduce their risk for subsequent cardiac problems (Case Management
Advisor)
Methods
 An integrative literature review was conducted to research the topics of major cardiac events, cardiac rehabilitation, and
cardiac rehab outcomes
 CINAHL electronic database was used for research purposes
 The date range for selected research was 2008-2014
 A nurse at a local hospital cardiac rehab program was consulted, as well as their website which they encourage their
patients to use for reference and information.
 Further teaching and research in the area of cardiac research is needed. Many patients who suffer a cardiac event are not
using their cardiac rehab benefits. An expert medical association calculates that only 14% to 35% of bypass patients get
cardiac rehab. Some patients never hear about it from their doctors. Others, older women in particular, tend not to use it,
even when their doctors prescribe it (Don’t skip cardiac rehab after an event).
 Patient education improves outcomes for cardiac patients
by teaching them how to make the changes
 Greater knowledge about heart disease and how to
achieve positive outcomes reduces fear and anxiety
Results
 Hospital admissions for cardiac disease exceed six million each year at a cost of $393.5 billion U.S., and mortality
rates exceed 900,000/year. (Scotto, et al). A study was conducted to determine cardiac rehab participants’ knowledge
of their diet and exercise regimen and the degree of adherence to diet and exercise two months after completing cardiac
rehab.
 Of 174 participants, 111
(64%) completed the entire
protocol. One hundred and
fourteen (65%) returned the
surveys and 137 (79%)
completed the follow up
call. Research has
indicated that post-cardiac
rehab, rates for diet and
exercise adherence were
poor. The failure to
develop strong practices
that promote healthy daily
diet and exercise habits
indicates a need for
interventions to improve
adherence beginning in the
immediate post-cardiac
rehab period and also
within the cardiac rehab
program itself (Scotto, et
al).
Cardiac rehab programs can improve patient health: education is a key
to successful lifestyle change (2008). Case Management Advisor,
19(11), 127-128.
Cardiac rehab: The road back to heart health. (2010). Consumer
Reports on Health, 22(9), 10.
Don't skip cardiac rehab after a heart event. (2013). Harvard Heart
Letter, 24(3), 3.
Ellismedicine.org. 2014. Customized Cardiac Rehab. Helping patients
return to
normal activity.
Scotto, C. J., Waechter, D. J., & Rosneck, J. (2011). Adherence to
Prescribed Exercise and Diet Regimens Two Months Post-Cardiac
Rehabilitation. Canadian Journal Of Cardiovascular Nursing, 21(4),
11-17.
Acknowledgements
We would like to acknowledge the following for their help in making this research
possible:
Ellis Hospital Cardiac Rehab Program, Schenectady, NY
Ellis’ cardiac rehabilitation is certified by the American Association of Cardiovascular
and Pulmonary Rehabilitation (AACVPR).
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