Page 44 - Petelin, Ana. 2024. Ed. Zdravje delovno aktivnih in starejših odraslih | Health of the Working-Age and Older Adults. Zbornik prispevkov z recenzijo | Proceedings. Koper: University of Primorska Press

Staff Composition
To monitor, record, and account for the services performed within the new
programme, ZZZS, in collaboration with the Internal Clinic of UKC Ljublja-
na, has defined a new list of outpatient cardiac rehabilitation services and a
new calculation for planning and financing the new team, consisting of 5.30
full-time equivalents (FTEs). This includes 1.20 FTEs for a specialist doctor,
1.50 FTEs for a registered nurse or senior nurse, and 1.50 FTEs for a physiother-
apist (Kos, 2020).

Rehabilitation Process
After an examination by a specialist doctor and a stress test, candidates are in-
vited to the outpatient cardiac rehabilitation. An initial assessment is conduct-
ed, including measurements of height, weight (to calculate BMI), and waist cir-
cumference. At the end of the rehabilitation, these measurements are repeated,
44 with the exception of body weight which is monitored weekly.
Blood pressure management is crucial for cardiac patients. Patients are
zdravje delovno aktivnih in starejših odraslih | health of working-age and older adults
taught to measure their blood pressure at home twice daily and as needed.
Blood pressure is measured before and after exercise during rehabilitation. If
the blood pressure is too high or too low, or if there is nausea, chest tightness,
or any other discomfort, exercise is contraindicated. Blood pressure usually
drops by about 10 mmHg after physical exertion.
It is recommended that patients with myocardial infarction warm up
thoroughly before exercise, starting with approximately 10 minutes of whole-
body warm-up. The warm-up also aims to introduce patients to various flex-
ibility and strength exercises they can continue at home after completing re-
habilitation. To enhance motivation, we use various aids such as elastic bands,
hand weights or wrist and ankle weights, sticks, and balls. Stretching and
breathing exercises are also included to teach patients to perform exercises cor-
rectly on their own.
Global studies have shown that 36 visits or more are required to achieve
the desired effects, equating to 12 weeks of rehabilitation, three times a week
(Servey and Stephens, 2016). Patients who complete 36 sessions of cardiac reha-
bilitation have a 14 % lower risk of death compared to those who only complete
24 sessions, and a 47 % lower risk compared to those who only attend one ses-
sion (Menezes et al., 2014). It is recommended that patients start physical ex-
ercise after a heart attack by participating in CR, which provides appropriate
safety and supervision during exercise (Vižintin Cuderman, 2019).
At General hospital Izola (SBI), we also follow these global standards. Pa-
tients typically attend rehabilitation 24 or 36 times, usually three times a week,
occasionally twice. The patient’s heart function is monitored throughout the
exercise with a monitor (Servey and Stephens, 2016). Each patient wears an
elastic strap around the chest with an ECG monitor attached, which is con-
nected to a computer via a Bluetooth system.