Cardiac rehabilitation at AUBMC : clinical protocols and the role of the advanced practice nurse -

Abstract

Coronary artery disease and heart failure are the two most common cardiac diseases, mandate changes in lifestyle, mainly diet, exercise, smoking cessation, in addition to taking prescribed medications in order to prevent recurrent exacerbations and to reduce cardiovascular risk. Cardiac rehabilitation programs provide the infra-structure that allows cardiac patients to change unhealthy behavior and improve their functional capacity.The history of cardiac rehabilitation started in the late 60s, since then cardiac rehabilitation is being delivered mainly by three international models: American, British, and Australian model. The evidences has shown many beneficial effects on the outcome of cardiovascular diseases patients including: reducing the risk of a future cardiac events by stabilizing, slowing, or even reversing the progression of cardiovascular diseases; improving the clinical outcomes of patients with various cardiovascular diseases; and significantly reducing the cardiovascular mortality, and hospital readmission.The aim of this project is to develop the clinical protocols and documentation forms of the cardiac rehabilitation program at American University of Beirut Medical Center (AUBMC), with an emphasis on the role of the advanced practice nurse. The proposed cardiac rehabilitation program is adapted from the three international cardiac rehabilitation models and aligned with latest guidelines of managing the risk factors of the cardiovascular diseases. The proposed cardiac rehabilitation program for AUBMC follows a clinical pathway consisting of six stages, which starts with patient presentation, then assessment and enrolling of the patient in the program, then the patient goes into in-hospital cardiac rehabilitation, after the discharge from the hospital, the patients are enrolled in out-patient rehabilitation program, the patients then are assessed at the end program, and discharged to a follow-up phase.