Cardiac Rehabilitation- an untapped resource
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
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
- 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.