CARDIAC REHABILITATION
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- Dale Webb
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1 Paul Peacock Cardiac Rehabilitation Nurse Friday, 4 August
2 The rehab Team Chris Murphy Kate O Reilly Paul Peacock Increased to 2 FTEs March 06 Wellington & Kapiti Coast MDT involvement Friday, 4 August
3 To empower patients to initiate and maintain lifestyle changes To improve quality of life through identification and treatment of psychological distress To facilitate the patients return to a full and active life by enabling the development of their own resources. Friday, 4 August
4 Target population Acute Coronary Syndrome Post Angiogram / PCI Post MI Post Cardiac Surgery Heart Failure.. Friday, 4 August
5 Phase 1 Identification Education packs Disease process Risk Factors Lifestyle modification Meds Transition back to community Invitation with advise and encouragement for phase 2 Friday, 4 August
6 Phase 2 Outpatient based rehabilitation Home based Exercise rehabilitation program Telephone support Advise and support to phase 3 Nurse led clinics Friday, 4 August
7 Phase 3 Professional advice and support Well.heart /Well.heart north Transitional support from phase 2 Community groups Pacific / Maori linkages Friday, 4 August
8 Patients Diagnosed With Cardiology Diseases by Region Number of Patients Wellington City Porirua City Kapiti Coast District Region Angina MI IHD Total Patients* Friday, 4 August
9 Cardiac Rehab Programme Attendance by Wellington City Cardiology Inpatients 47 12% Yes No % Friday, 4 August
10 Cardiac Rehab Programme Attendance by Porirua City Cardiology Inpatients 6 5% Yes No % Friday, 4 August
11 Cardiac Rehab Programme Attendance by Kapiti Coast District Cardiology Inpatients 6 3% Yes No % Friday, 4 August
12 Phase 2 rehab growth January February March 16.6 April 18.5 May 20+ Friday, 4 August
13 BENEFITS Reduction in overall mortality and morbidity 25-30% O Connor G, Burling J, Yusuf S, et al. An overview of randomised trials of rehabilitation with exercise after myocardial infarction. Circulation 1989; Hedback B, Perk J, Wodlin P. Long term reduction of cardiac mortality after myocardial infarction: 10 year results a comprehensive cardiac rehabilitation programme. Eur heart J. 1993; 14: Friday, 4 August
14 Describing Disease process in a patient language Risk / lifestyle management Smoking / Physical activity / nutrition / identification of individual goals Lipids / BP / Diabetes Drugs / Aspirin / bblockers /Statins Psychological depression and social isolation Friday, 4 August
15 ISSUES Transport < 65 years >75 years Female 20% less likely to be referred Doolan-Noble F, Broad J, Riddell T, North D. cardiac rehabilitation services in New Zealand: access and utilisation. The New Zealand Medical Journal. 117; No 1197 Time of day (12-2 Wednesday) Location Wellington campus Friday, 4 August
16 Strengthen Kenepuru and Kapiti links Develop Nurse led clinics Strengthen MDT involvement Maori liaison nurse Physio Dietetics Pharmacy Psychological Cardiologist Friday, 4 August
17 Transition process from phase 2 to 3 PHO and Practice Nurse involvement Utilise Heart guide Aotearoa (NHF) Community groups Pacific / Maori linkages GP Rehab Treatment Friday, 4 August
18 Massey University clinical exercise physiologist students Fitness centres City Council programme Green prescription linkage Develop a Minimum Data Set Research Otago / Massey / Heart Foundation Why improve.. Friday, 4 August
19 Coronary heart disease death rates are now increasing for young and middle-aged people Improvement and extension of heart failure and cardiac rehabilitation programmes with service delivery models to meet the needs of Maori and Pacific and low income groups -Six Point Action Plan editorial "Heart Health Future Forecast Adverse. An Alarm Call to Action Across the Continuum" Heart Foundation Medical Director Professor Norman Sharpe Friday, 4 August
20 embracing what I have been through without the get over it move on attitude of the past, using the experience to enrich my life enriching life s experience with an increased daily awareness of what I need to do -Paul Grimes heart rehab patient Friday, 4 August
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