Care of Patients with Cardiovascular DisordersCardiac rehabilitation in skilled nursing facilities: A missed opportunity
Section snippets
Methods
This exploratory study used a retrospective and cross-sectional design. In Phase 1, we examined the medical records of patients admitted to 1 of 2 large tertiary hospital-based SNFs. In Phase 2, a questionnaire was completed by healthcare professionals working in these facilities, to validate the results of the medical record review. Both phases of the study (the medical record review and staff questionnaires) were approved by the institutional review boards of each hospital-based SNF. Staff
Characteristics of Patients in SNFs After a Cardiac Event
The demographics of the sample are listed in Table 1. The mean age was 77.5 years (range, 65 to 95 years), 78% were female, 43% were black, and the majority had heart failure. The mean length of stay in the SNF was 12 days (Standard Deviation = 10 days). When patients were discharged from the SNF, 70% went home, 16% were readmitted to acute hospital care, and 14% went to a nursing home.
Patient characteristics are listed in Table 1. Overall, 19 participants (21%) had 1 or more cardiac disorders
Discussion
Neither of the 2 AACVPR recommended Phase IB postacute cardiac care rehabilitative components (exercise and education) were integrated into SNF practice in a structured or consistent manner. Not providing these cardiac-specific care interventions is a missed opportunity for ensuring that cardiac patients receive complete and safe rehabilitation, focusing on their chronic disease during SNF transitional care.
Monitoring exercise tolerance is an essential component to ensure that the patient's
Acknowledgments
This study was supported by Multidisciplinary Clinical Research Training Program Grant K12RR023264, and was made possible by grant KL2RR024990 from the National Center for Research Resources (a component of the National Institutes of Health) and the National Institutes of Health Roadmap for Medical Research. Its contents are solely the responsibility of the authors, and do not necessarily represent the official views of the National Center for Research Resources or National Institutes of
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Skilled Nursing Facility Quality Rating and Surgical Outcomes Following Coronary Artery Bypass Grafting
2022, Seminars in Thoracic and Cardiovascular SurgeryCitation Excerpt :First, joint hospital-SNF partnerships could enhance quality control within SNFs. Prior studies have suggested a benefit of hospital-SNF partnerships with decreased readmission rates.19-21 However, we recognize that the implementation of such partnerships may not be widely applicable to under-resourced areas.
Cardiac Rehabilitation as Part of Management in Postacute Care: Opportunities for Improving Care
2019, Clinics in Geriatric MedicineCitation Excerpt :Unfortunately, these recommendations are not consistently integrated into practice, specifically in postacute settings such as SNFs, resulting in unsafe practices and misuse of CR therapies. In 1 study of SNF residents receiving exercise therapy, only 5% of medical records indicated the use of structured exercise tolerance monitoring, despite a documented 33% prevalence of patient symptoms (dizziness, fatigue) experienced during exercise.2 It is critically important that medical staff incorporate consistent exercise tolerance monitoring in CR sessions specifically for elderly patients, because there are no data regarding the safety of CR in this population in an SNF or HHC setting.
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2018, Annals of Thoracic SurgerySkilled Nursing Facility Care for Patients With Heart Failure: Can We Make It “Heart Failure Ready?”
2016, Journal of Cardiac FailurePreoperative Frailty Increases Risk of Nonhome Discharge after Elective Vascular Surgery in Home-Dwelling Patients
2016, Annals of Vascular SurgeryLong-term fate of patients discharged to extended care facilities after cardiovascular surgery
2013, Annals of Thoracic Surgery