Cardiac rehabilitation in skilled nursing facilities: A missed opportunity

Abstract Background After hospitalization for a cardiac event, older adults are frequently discharged to a skilled nursing facility (SNF) for postacute care. The American Association of Cardiopulmonary Rehabilitation recommends that cardiac care be integrated into procedures at SNFs. Objective We un...

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Bibliographic Details
Published in:Heart & lung 2012-03, Vol.41 (2), p.115-124
Main Authors: Dolansky, Mary A., RN, PhD, Zullo, Melissa D., PhD, MPH, MA, Hassanein, Salwa, RN, PhD, Schaefer, Julie T., MS, RD, Murray, Patrick, MPH, MD, Boxer, Rebecca, MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cardiac rehabilitation
Cardiovascular
Critical Care
Cross-Sectional Studies
Discharge
Female
Follow-Up Studies
Heart
Heart Diseases - rehabilitation
Humans
Length of Stay - trends
Long term health care
Male
Nursing
Nursing Staff, Hospital - standards
Older adults
Patient Discharge - trends
Patient safety
Pulmonary/Respiratory
Rehabilitation Centers - statistics & numerical data
Retrospective Studies
Skilled Nursing Facilities - statistics & numerical data
Skilled nursing facility
Surveys and Questionnaires
United States
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Summary:Abstract Background After hospitalization for a cardiac event, older adults are frequently discharged to a skilled nursing facility (SNF) for postacute care. The American Association of Cardiopulmonary Rehabilitation recommends that cardiac care be integrated into procedures at SNFs. Objective We undertook this research to describe the characteristics of patients in SNFs after a cardiac event and the cardiac care delivered at SNFs. Methods A dual approach included (1) a retrospective medical record review of consecutive patients admitted to 2 hospital-based SNFs after a cardiac event (n = 80), and (2) surveys from healthcare professionals (n = 21) working in these facilities. Results Thirty-two percent of patients were not candidates for cardiac rehabilitative interventions because they had been rehospitalized, discharged to long-term care facilities, or manifested contraindications to exercise. No standard assessment of exercise tolerance was evident, and although 70% of patients were discharged home, cardiac-specific discharge education was seldom evident. Healthcare professionals in SNFs reported that standard procedures for cardiac care services were lacking. Conclusion The integration of cardiac care into SNFs is important to ensure the safety of therapy and improve the transition of patients from SNFs to outpatient cardiac rehabilitation programs.
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2011.08.006