Dissertations and Theses @ UNI


Open Access Thesis


Nurses--Iowa; Heart--Diseases--Nursing; Heart--Diseases--Patients--Rehabilitation; Nurses; Iowa;


The purpose of this study was to describe the professional backgrounds, experience, roles and responsibilities, and selected attitudes and opinions of cardiac rehabilitation nurses in the state of Iowa. Nurses were identified through the membership lists of the Iowa Association of Cardiopulmonary Rehabilitation (IACPR) and the American Association of Cardiovascular Pulmonary Rehabilitation (AACVPR). Additional programs were identified through the Iowa Blue Cross/Blue Shield approved list of Cardiac Rehabilitation Programs in the state. A total of 100 surveys were mailed. The data results, based on the responses of 71 (71%) of these nurses, are summarized below.

The basic nursing education of these nurses revealed 31 (44%) were diploma graduates, 26 (37%) were Associate Degree graduates, and 14 (20%) were Baccalaureate Degree graduates. Nearly onefourth of the sample had increased their basic nursing education with a higher degree. In addition, 96% were Advanced Cardiopulmonary Life Support (ACLS) certified while only 4 (6%) possessed any of the American College of Sports Medicine (ACSM) certifications available for cardiac rehabilitation professionals. However, only 11 (16%) were very familiar with the certification process.

Most nurses in the sample, however, did belong to one or more professional organizations with only 8 who did not have any professional associations. Only 3 (4%) had active ACSM memberships.

Varied methods were used by these nurses to enhance their knowledge and skills but self-learning, locally sponsored conferences and workshops, and training by senior staff were the most commonly reported methods. While 30 (42%) had taken some formal coursework beyond their basic nursing education, 18 (26%) had not. Only 8 (12%) reported having taken advanced physiology while 10 (14%) had taken exercise physiology. The majority of the nurses rated their knowledge of exercise physiology between fair and good.

The majority (90%) of the nurses reported they are currently working in Phase II; 38 (54%) in Phase I; and 19 (27%) in Phase III. The past professional experiences of the sample varied but 59 (83%) had some type of critical care background.

Current roles and responsibilities of this sample of nurses were dependent on the specific phase of cardiac rehabilitation and the other professionals available. Three of the most commonly performed tasks were: (a) summarizing the patient's response to exercise; (b) obtaining blood pressures during exercise; and (c) supervision of patients in a Phase II exercise program. Graded exercise testing (GXT) and exercise prescription based on GXT results were done infrequently by this sample of nurses.

Most (94%) of the cardiac rehabilitation programs represented by these nurses were hospital based. The multidisciplinary nature of this subspecialty was demonstrated by the presence of various professionals on the team. Physicians, dieticians, additional nurses, and physical therapists were the most frequently reported regular program staff. Exercise physiologists at a master's or doctorate level were available in only 14 (20%) of the programs.

There was general consensus of opinion on the statements soliciting the attitudes and opinions of these Iowa nurses on exercise aspects of cardiac rehabilitation. Most nurses felt that an understanding of exercise science and physiology was necessary for cardiac rehabilitation nurses; that they should be involved with the exercise aspects of cardiac rehabilitation; and that they should be involved with the administration of GXTs. However, only 25 (35%) felt that nurses should perform GXTs without a physician, even with proper education and training. While most nurses agreed that their basic nursing education did not prepare them for their roles and responsibilities in cardiac rehabilitation nursing, only 31 (44%) felt they had been in situations in which they did not feel academically or clinically prepared. Finally, most (83%) nurses agreed that there should be some type of accreditation of cardiac rehabilitation programs to insure optimal standards of care as well as basic staff qualifications.

Year of Submission


Degree Name

Master of Arts


School of Health, Physical Education, and Leisure Services

First Advisor

Jane E. Richards

Second Advisor

William Ryan

Third Advisor

Forrest A. Dolgener


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Date Original


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