The effect of cardiac rehabilitation on patients’ functional status and readmission rates among adult heart failure patients Heart failure (HF) is a chronic condition which greatly affects patients’ quality of life, functional status and threatens their independence; it is also associated with high hospitalizations and mortality rates. To ensure the best possible outcome, healthcare professionals continuously seek opportunities to improve the quality of care delivered to this population.
Purpose
The purpose of this evidence-based project is to determine if cardiac rehabilitation for heart failure patients discharged from the hospital would improve their functional status and result in fewer hospitalizations.
Relevance
Heart failure
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The goal of comprehensive cardiac rehabilitation is to help patients with heart diseases regain their physical and mental status by providing them with an individualized exercise plan, education, and counseling. The safety and benefits of exercise for patients with heart diseases are well documented. The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) recommend regular exercise and acknowledge value of cardiac rehabilitation for stable HF patients (Yancy et al., 2013). Exercise improves cardiac muscle perfusion, dilates coronary vessels, and stimulates development of collateral circulation; it also strengthens skeletal muscles and increases cerebral blood flow (Anderson & Taylor, 2014; Garcia et al., 2013). Additional education allows to individualize and reinforce information obtained at discharge, and counseling can provide the needed psychological support as many heart failure patients struggle with depression. This holistic approach is congruent with one of the topics of Healthy People 2020: “Health-related quality of life and well-being” of each individual, which aims at achieving the well-being in all domains of life: physical, mental, social and emotional (Healthy People 2020,
In this 21st century, there are more and more policies and guidelines that focused on long term conditions as these conditions are incurable but only can be controlled and progressed with long term management. In Northern Ireland, a policy framework “Living with Long Term Conditions” had been introduced and addressed about long term conditions (LTC) that needs high quality of care. This policy provides a better outcome with supporting good practice through 6 key development areas. The 6 key principles are essential in helping people with LTC to receive a better care, treatment and support. First area is partnership between the service user and the collaboration team whereby communication skill is highlighted to encourage service users to play an active role in managing their own conditions with individual care plan. Next, self-management is also another key principle to be developed so that those people with LTC managed their condition effectively which may progress over time. Through training and education on acquired skills is a good start to promote self-management strategy as they able to deal with flare-ups, condition and lifestyle. Thus, information is vital in helping them understand their own condition and knowing what is the best for them in order to increase their quality of life. A medicines management service help in bringing the best outcome for LTC patients while carer also need to maintain their own health to continue their caring role and act as a safeguarding through the provision of the support. Last principle is improving care and services at the right time and right way to prevent readmission and prolong hospital stay (DHSSPS, 2012).
Scottish Intercollegiate Guideline Network (SIGN) 95 (2007): Management of Chronic Heart Failure (Online). Available at: http://www.sign.ac.uk/pdf/sign95.pdf (Accessed 8th June 2010)
The interpretation of quality health care varies with each person. Some place emphasis on the ability to access various treatments without interference. Others value the feature of being able to simply select one’s provider. Quality health care, according to the Institute of Medicine (2001), can be defined as care that is “safe, effective, patient-centered, timely, efficient and equitable” (p. 3). Furthermore, it should account for, in detail, a patient’s medical history, and improve overall patient well-being.
Standardizing The Hospital Discharge Process for Patients with Heart Failure to Improve the Transition and Lower 30 day Readmission. http://www.cfmc.org/integratingcare/files/Remington%20Report%20Nov%202011%20Standardizing%20the%20Hospital%20Discharge.pdf
“Heart failure is among the most common diagnoses in hospitalized adults in the United States” (Cole
Savage, P., Lee, M., Harvey-Berino, J., Brochu, M., & Ades, P. (2002). Weight Reduction in the Cardiac Rehabilitation Setting. Journal of Cardiopulmonary Rehabilitation, 22:154-160.
...ease. In this level, health care providers are aiming towards the goal of enhancing quality of life. In addition, disease should monitor closely by the health care providers, and patients will require frequent lab works and regular check-ups.
...ts, electrocardiogram, sonogram and cardiac rehabilitation. As a clinical observer, I found an opportunity to create a solid foundation on patient diagnosis and treatment, and not to mention, long hours with charting and recording patients’ information.
Chronic illness issues can include managing their illness, the cost of taking care of the illness, etc. Many people who suffer from a chronic illness suffer a lot trying to manage their illness on a daily basis. According to a website called NCOA.org, “About 80% of older adults have one chronic disease. 68.4% of Medicare beneficiaries have two or more chronic diseases and 36.4% have four or more. Chronic diseases can affect a person’s ability to perform important activities, restricting their engagement in life and their enjoyment of family and friends”
Meeting the needs and what is best for the patient which is the outcome of the care, building
Patients with chronic diseases do not receive established and operative treatments to help them successfully manage their condition. These complications are aggravated by an absence of organization of care for patients with chronic diseases. Nevertheless, the fundamental disintegration of the health care system is not unexpected given that health care providers do not have the imbursement support or other tools they need to interconnect and work together successfully to improve patient care (Brennan et al., 2009; Renders et al., 200;).
When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most resent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement from the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.
... patients with heart failure: Impact on patients. American Journal of Critical Care, 20(6), 431-442.
Thomas-Kvidera, D. “Heart Failure from Diastolic Dysfunction Related to Hypertension: Guidelines for Management.” Journal of the American Academy of Nurse Practitioners 17.5 (2005): 168-175. CINAHL with Full Text. Web 01 Dec. 2013.
Rehabilitation Nurses are a specialized group of healthcare providers within the sphere of the medical field that focus on rehabilitation, the process of helping people physically recover from, trauma, disability or illness (The Rehabilitation Staff Nurse, n.d.). The primary purpose of a Rehabilitation Nurse revolves around creating a therapeutic environment for a patient and assisting the impaired individual reach maximum function. Generally, their role involves developing a treatment plan that encourages physical activity and helping patients adapt to a new, altered lifestyle (The Rehabilitation Staff Nurse, n.d.). Since rehab treatment relies on trust, support and motivation, the nurse-patient relationship is pivotal to reach the highest