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Cardiac Rehabilitation- an untapped resource

By Kelly Seward, RN - The Wellness Institute – Winnipeg

When someone has a heart attack the priority in resuscitation, stabilization and then recovery. But for the patient returning home after a typical four or five-day hospital stay, the priority is on making the lifestyle adjustments, diet, and exercise and taking medications that will prevent a reoccurrence. The difficulty is how do we as nurses make sure they get the information, and follow-up that they need?

Cardiac Rehabilitation is a comprehensive, multidisciplinary approach to the prevention, stabilization and possible reversal of cardiovascular disease. Cardiac Rehab is a sixteen-week education and exercise program at the Wellness Institute at Seven Oaks Hospital and the Kinsmen Reh-Fit Centre

The program provides a second chance to make sure patients understand their symptoms, and limitations, and realize the importance of compliance with prescriptions. It provides a chance to answer the questions about diet that come up once a patient is back in her own kitchen. It helps them to develop a safe regimen for exercise that will restore them to health and create a pattern that ensures they have enough physical activity in the future to maintain cardiovascular strength.

In other words, Cardiac Rehab builds on, and reinforces the care and teaching that nurses and other health care practitioners do during the hospital stay. Patients in a Cardiac Rehab program feel safer, stronger and more confident as a result of their participation. We see your patients at their best, shaking off their illness and becoming strong and well. Sometimes we wish you could come and see what you started in hospital.

But Cardiac Rehab isn’t just about making patients feel good; it produces concrete results. Evidence-based research has concluded that providing that transition back to independence greatly improves patient outcomes in both the short and long term.

The benefits of Cardiac Rehab include:

  • Reduction in mortality of up to 25% compared to standard care. This is clinically equivalent to the benefit from taking Beta blockers and ACE inhibitors, but unfortunately not as widely prescribed.
  • Reduction in frequency and severity of angina as well as increased functional capacity in heart failure
  • Improved exercise tolerance in all patients, including, elderly, frail and patients with CHF
  • Improved lipid profiles
  • 16 to 26% reduction in smoking
  • Improvements in psychological well being

But in Canada, 15% or less of all patients with Myocardial Infarctions participate in a cardiac rehabilitation program! To increase the numbers in Manitoba we have to improve our system for referral. Cardiac Referral is part of the MI Care Map used in Winnipeg Regional Health Authority hospitals, but not all patients are referred, and many don’t even learn about the program.

There is a unique opportunity to dramatically improve cardiovascular patients’ participation in cardiac rehabilitation. While still in hospital, cardiac surgery or MI patients can be referred to cardiac rehabilitation upon release to either the Wellness Institute at Seven Oaks General Hospital or the Kinsmen Reh-Fit Center. Cardiac Rehab has the potential to reduce the load at emergency and Cardiac Care wards, but we need to get more patients into the program.

The cost to the patient of the cardiac rehabilitation program is $160.00 plus GST. Some health insurances cover the cost and a subsidy may be available based on income. The program is available to all patients with a diagnosed cardiovascular disease.

For more information, please contact the Wellness Institute at 632-3907 or the Kinsmen Reh-Fit Centre at 488-8023.

Sources for statistics:

1 Canadian Association of Cardiac Rehabilitation (1999). Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention (1st ed.). Winnipeg, Manitoba

2 US department of Health and Human Services (1995). Cardiac Rehabilitation: Clinical Practice Guideline. Publication number 96-0672

CCRF would like to thank The Wellness Institute for their contribution to the web

The articles, on the Cardiac Health Foundation of Canada website, are presented with the understanding that the Foundation is providing information only and not rendering medical advise. Please check with your family physician, specialist or health care professional before implementing any of the ideas expressed in these articles.

 
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