Fischer Jane P
Cardiac Rehabilitation, Sarasota Memorial Hospital, Florida, USA.
J Cardiovasc Nurs. 2008 Nov-Dec;23(6):474-9. doi: 10.1097/01.JCN.0000338934.63661.c5.
The pervasive negative impact of cardiovascular disease in the United States is well documented. Although advances have been made, the campaign to reduce the occurrence, progression, and mortality continues. Determining evidence-based data is only half the battle. Implementing new and updated clinical guidelines into daily practice is a challenging task. Cardiac rehabilitation is an example of a proven intervention whose benefit is hindered through erratic implementation. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA) have responded to this problem by publishing the AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services. This new national guideline recommends automatic referral to cardiac rehabilitation for every eligible patient (performance measure A-1). This article offers guidance for the initiation of an automatic referral system, including individualizing your protocol with regard to electronic or paper-based order entry structures.
心血管疾病在美国普遍存在的负面影响已有充分记录。尽管已取得进展，但减少其发生、发展和死亡率的行动仍在继续。确定基于证据的数据只是成功的一半。将新的和更新的临床指南应用于日常实践是一项具有挑战性的任务。心脏康复是一种已被证实有效的干预措施，但由于实施不稳定，其益处受到阻碍。美国心血管和肺康复协会（AACVPR）、美国心脏病学会（ACC）和美国心脏协会（AHA）针对这一问题发布了《2007年AACVPR/ACC/AHA心脏康复转诊及心脏康复/二级预防服务提供绩效指标》。这项新的国家指南建议对每一位符合条件的患者自动转诊至心脏康复（绩效指标A-1）。本文为启动自动转诊系统提供指导，包括根据电子或纸质医嘱录入结构对方案进行个性化设置。
