South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting - PowerPoint PPT Presentation

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South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting

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South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting Wednesday 16th February 2011 Glynclydach Hotel, Longford Road, Dyffryn, Neath, SA10 7AJ – PowerPoint PPT presentation

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Title: South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting


1

South Wales Cardiac NetworkCardiac
Rehabilitation Advisory Group Meeting Wednesday
16th February 2011 Glynclydach Hotel, Longford
Road, Dyffryn, Neath, SA10 7AJ
2
Background to Service
  • Both services Established in1994
  • Cwm Taf South ( Based at RGH)
  • Initially service for patients post MI (1 Nurse)
  • Extended 2000 with substantive funding to include
    all CHD Patients
  • Extended 2010 to include Heart Failure Valve
    replacement, ICD and transplant patients.
  • Cwm Taf North (Based at PCH)
  • Initially Post MI, Post Surgical (2 Nurses)
  • 2001 Inequalities in Health funding extended
    service to include patients with Angina. Staffing
    increased with 2 extra nurses, physiotherapy and
    AC, funding for volunteer driver service.

Total Population 290,100
3
Skill Mix
  • South
  • 1Band 7
  • Nurse/Manager.
  • 3 WTE Nurses Band 6
  • 1 WTE Physio Band 7
  • 1 WTE Physio Band 6 (Rotational Post)
  • 1 WTE OT Band 7
  • 1 WTE Dietician Band 7
  • 10 hrs Pharmacy Band 8a
  • North
  • 1 Band 7 Nurse/Manager.
  • 3 WTE Nurses Band 6
  • 15hrs Band 7 Physio
  • 22.5 A/C band 2
  • 1Hr Good will dietetic each 6weeks
  • BACR F/T 9 hrs per week
  • 8 Volunteers funded by Local Heart Support Group

4
Phase 1
  • Both Sites
  • All inpatients identified by daily trawl of
    CCU and all medical wards, and seen by nurses at
    least once during admission.
  • Allocated Case Management Model in PCH
  • Shared Nurse Management in RGH

5
Phase 2
  • On both site all patients contacted by telephone
    as per NSF QR and assessed.
  • Home visits or clinic appts offered based on
    clinical need/choice.
  • Rehabilitation needs identified with patient and
    menu based services offered.

6
Phase 3
  • Both sites
  • Stand alone education.
  • Exercise class and group discussion
  • Or both
  • South run an open programme which also includes
  • Hydrotherapy Phase 3 4.
  • Home based R2R.
  • North, closed programme which also includes
  • Nurse led clinic reviews for non-attendees at
    phase 3 rehabilitation.
  • Phase 4 taster sessions at week 6 of Phase 3

7
Phase 4
  • South
  • 4 long term exercise classes all provided within
    NERS
  • Phase 4 Hydrotherapy
  • Cardiac bowls groups x2 facilitated by Cardiac
    Rehabilitation OT Nurses.
  • Signpost to Walk for health or local support
    group.
  • North
  • 3 maintenance classes run by BACR instructors
  • Funded by LHB and patient support group
  • Refer to 3 NERS classes (as added option for
    exiting phase 3)
  • Signpost to Walk for health
  • Recent increase in Heart Support Group activity
  • Expert Patient Programme

8
Significant Successes
  • South
  • Developing extended services e.g. Cardiac Bowls,
    Hydrotherapy classes.
  • Integration of heart failure and valve patients
    into Cardiac Rehabilitation within current
    resources.
  • Audit presentation at ESC congress 2010.
  • North
  • Responsive service, meeting needs of all priority
    groups for CR
  • Re- configuration of physiotherapy hours
    (Yellowbelt Project)
  • Good Team working
  • Multi/up skilling of nurses
  • Good working relationships with support group
    enhancing funding opportunities

9
Current Challenges
  • Maintaining Current service provision within
    current financial climate
  • Minimal MDT input (North)
  • Maintaining MDT input (South)
  • Integrating the services across North South
  • Demonstrating effectiveness of CR through the
    development of a robust Audit Tool

10
Anything Else?
  • How can we ensure CR is seen and valued as an
    integral part of CHD management?
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