COMPLIANCE WITH SELECTED AACVPR GUIDELINES IN CARDIAC REHABILITATION PROGRAMS IN FOUR MIDWESTERN STATES

Abstract

453 The American Association of Cardiovascular and Pulmonary Rehabilitation(AACVPR) established guidelines in 1995 for cardiac rehabilitation programs which reflect state-of-the-art procedures that programs should adhere to in their daily operations. All directors/coordinators (N=51) of cardiac rehabilitation programs (obtained from the AACVPR membership directory) in four midwestern states were surveyed to determine compliance to 61 selected AACVPR guidelines. Guidelines were grouped into four categories on the survey instrument: 1) Staffing/Instruction/Supervision (23 guidelines), 2) Emergency Procedures (9 guidelines), 3) Screening/Testing/Prescription (19 guidelines), and 4) Facility/Equipment (10 guidelines). Level of compliance (met or did not meet guideline) was determined using descriptive statistics for each of the 61 guidelines. The response rate was 86%. Most respondents (93% or more) indicated that they had met 19 of the 23 guidelines for Staffing/Instruction/Supervision. However, guidelines related to degree and certification qualifications did not produce a high adherence rate. Only 30% met the “preferred” guideline of an advanced degree and 74% met the “minimum” guideline of a bachelor's degree. Only 20% met the“preferred” or “minimum” guidelines for certification. The majority of respondents (91% or more) met all of the nine guidelines for Emergency Procedures. Of the 19 Screening/Testing/Prescription guidelines, 13 had a compliance rate of 86% or higher. The adherence rate for guidelines regarding an evaluation for exercise tolerance and an initial GXT was 66% and 16%, respectively. Four guidelines addressing resistance training procedures had a compliance rate ranging from 57% to 79%. All but one of the 10 guidelines regarding Facility/Equipment issues had a compliance rate of 84% or higher. Only 60% of the respondents indicated that their facility met the floor space guideline of 40-45 square feet per patient. Generally, compliance with the selected 61 AACVPR guidelines in this study was good. However, AACVPR guidelines in the following areas merit attention in order to ensure an adequate standard of practice: director/coordinator degree and certification qualifications, evaluation of exercise tolerance and initial GXT, resistance training procedures, and floor space per patient.