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Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN

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Page 1: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Pediatric Cardiac Rehabilitation Program

Lynne Telfer, RN

Page 2: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

IntroductionCongenital heart disease is the number 1 birth defect in the 

world. Heart disease is second only to asthma as the leading cause of illness in children

Every year in Saskatchewan there are about 140 children who are diagnosed with heart disease and approximately 70 children go out of province for cardiac surgery

Due to medical and surgical advances there are now more adults than children living in Canada with Congenital Heart disease

Page 3: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

My Inspiration

Page 4: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

What is a Pediatric Cardiac Rehab Program?

Similar to Adult Cardiac Rehabilitation Program

For children ages 6‐18 with Congenital or Acquired Heart Disease

Participation is voluntary with Pediatric Cardiologist approval

Page 5: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Components of the Program

Program will provide:Fun exercise programsNutrition informationFamily involvementEmotional supportEducation

Page 6: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Multidisciplinary Team

Multidisciplinary involvement in program development and implementationExercise physiologistDieticianPsychologistRegistered nursePatient and family

Page 7: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Benefits of Cardiac RehabilitationPsychologicalAbility to confidently manage physical activityIncreased sense of well beingSupport system

PhysiologicalIncreased cardiac functionIncrease exercise capacity and energy

EducationKnowledge of their specific cardiac issues

Page 8: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Boston Pediatric Cardiac Rehab Study

♥ A 12 week pediatric cardiac rehab study was done in 2005 by Dr. Jonathan Rhodes at the Children’s Hospital in Boston

♥ At the 7 month follow‐up testing they found significant, sustained improvements in exercise function in the participants who continued to exercise

♥ The participants also showed improvement in their behavior, self esteem and emotional state

Page 9: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Where do we go from here?

Parent and patient surveyPilot study Western Canadian Children’s Heart NetworkSaskatchewan Union of NursesCoronary Artery Rehabilitation Group

Page 10: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

12 KEY Patient and Family‐ Centered Practices

♥ Patients and families are seen as essential members of the health care team in all settings across the continuum of care.

♥ Staff and clinicians introduce themselves to patients and their family members in all encounters.

♥ Patients and families are supported in collaborative self‐management in ambulatory settings.

♥ Families are no longer viewed as visitors.♥ Patients and families are partners with staff and clinicians in 

enhancing patient safety.

Page 11: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Patients and families are encouraged and supported to participate in nurse change of shift report and rounds.

Patients and families have timely, useful information about medications.

Patients and families have access to a Rapid Response Team.Patients and families according to patient preference, have 

easy access to their clinical information, medical record, and the daily recording of care.

Page 12: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Patients and families are encouraged and supported in participating in the planning for discharge and other transitions.

Education and support are provided to front‐line nursing and allied health staff, physicians, unit leaders, and trainees for how to introduce themselves and how to collaborate with patients and families.

Patients and families participate in meaningful sustained ways in policy and program development, implementation, and evaluation; in quality improvement and safety initiatives; in facility design planning; and in professional education.

Institute for Patient‐and Family‐Centered CareBethesda, Maryland (www.ipfcc.org)

Page 13: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

Thank You

Saskatchewan Union of NursesWestern Canadian Children’s Heart Network Pediatric CardiologyCoronary Artery Rehabilitation GroupHealth Council of CanadaLittle Hearts Family Group Inc.Sean and Joanne Telfer

Page 14: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

“Appropriate educational and psychological support for the children and their families is the next 

challenge for all of us in the field of paediatrics.  How ironic it would be to have invested so much in early survival, only to allow the child to fail in life 

itself.”

Dr. Derek G. HumanMedical Director, Cardiac Sciences Program, BC Children’s HospitalHead of the  Division of Cardiology, University of British Columbia

Page 15: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

ReferencesHuman, DG (2009) Living with complex congenital heart 

disease. Paediatric Child Health, 14(3):161‐82Kendall et. al. (2003). The views of parents concerning the 

planning of services for rehabilitation of families of children with congenital cardiac disease. Cardiol Young, 13 (1), 20‐27.

Rhodes et. al. (2006). Sustained Effects of Cardiac Rehabilitation in Children with Serious Congenital Heart Disease.  Pediatrics, 118(3), 586‐593.

Statistics Canada. http://www.statcan.gc.ca/

Page 16: Pediatric Cardiac Rehabilitation Program - RPCU · Pediatric Cardiac Rehabilitation Program Lynne Telfer, RN. Introduction ... Pediatrics;116;1339‐1345 ♥The Heart and Stroke Foundation

References♥ Samorriba, G. et.al.(2008) Exercise Rehabilitation in Pediatric 

Cardiomyopathy. Pediatric Cardiology, 25(1):91‐102.♥ Norozi, K. et. al. (2005) Normality of Cardiopulmonary 

Capacity in Children Operated on to Correct Congenital Heart Defects. Archives Pediatric Adolescent Medicine;159:1063‐1068.

♥ Rhodes,T. et.al.(2005) Impact of Cardiac Rehabilitation on the Exercise Function of Children With Serious Congenital Heart Disease. Pediatrics;116;1339‐1345

♥ The Heart and Stroke Foundation of Canada. www.heartandstroke.ca/