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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., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self-Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation (CR) program were compared in a sample of 38 older adults (17 Cardiac TRUST, 21 usual care). At discharge from postacute care, the intervention group trended toward higher levels of self-efficacy for exercise outcomes than the usual care group. During the 6 weeks following discharge, the intervention group had greater attendance in outpatient CR and a trend toward more steps walked during the first week. The feasibility of the intervention was better for the home health care participants than for those in the skilled nursing facility. The provision of CR during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient CR for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted., (Copyright 2011, SLACK Incorporated.)

Purpose: The prevalence of metabolic syndrome in cardiac rehabilitation (CR) makes CR an ideal place to offer interventions to address metabolic syndrome–related risk. There is a lack of research related to the metabolic syndrome practices in CR. Therefore, the purpose of this research was to describe practices to assess CR patients for metabolic syndrome, interventions specific to metabolic syndrome, and staff knowledge and beliefs related to metabolic syndrome., Methods: This was a cross-sectional study of CR providers in Ohio (n = 94). Program practices and interventions and staff knowledge and beliefs were assessed and stratified on the program use of case management, program certification by the American Association of Cardiovascular and Pulmonary Rehabilitation, and staff profession., Results: At CR entry, 26% of the programs assessed patients for the metabolic syndrome and 8% had written guidelines for metabolic syndrome. Less than half of the staff (47%) was able to name 3 or more risk factors for metabolic syndrome. Programs using case management were more likely to identify metabolic syndrome (P < .001), measure waist circumference (P < .001), order a new lipid profile (P = .04) at program entry, and have written guidelines for managing metabolic syndrome (P = .01) than programs not using case management. No differences were observed in stratified analyses for the program certification or staff profession., Conclusions: The majority of CR programs do not assess patients for metabolic syndrome or have written guidelines for the metabolic syndrome. Opportunities exist for better management of metabolic syndrome in CR.