Respiratory Rehab

Sinai Post-Acute, Nursing & Rehab Center has partnered with NJRA (New Jersey Respiratory Associates) to deliver world-class pulmonary rehabilitation!

Our Pulmonary Rehabilitation Program offers concentrated respiratory therapy and pulmonary rehabilitation services to help patients transition back home after being hospitalized for COPD, Pneumonia, or other lung conditions. Our multi-disciplinary team, led by our in-house respiratory therapists, provide:

• Respiratory therapy treatments
• Respiratory focused physical, occupational, and speech therapy
• Nutritional & psychosocial counseling and education
• OSA and non-invasive ventilation (BiPAP/CPAP/AutoPAP) management
• Tracheostomy care and weaning
• High-flow oxygen therapy
• Breathing exercises, incentive spirometry, chest physiotherapy

Program Detail

Introduction

Pulmonary rehabilitation is a service intended to help an individual breathe better, increase strength, and live more independently. Any person with a chronic lung disease might benefit from pulmonary rehabilitation techniques. Examples of lung conditions include chronic obstructive pulmonary disease (COPD), asthma, chronic bronchitis, pneumonia, or pulmonary fibrosis.

Outpatient pulmonary rehabilitation is provided in a doctor’s office or a hospital outpatient setting and is directly reimbursed through Medicare. Skilled nursing facilities can use the same pulmonary rehabilitation techniques to achieve better clinical outcomes for their residents. Furthermore, a SNF is an ideal transitional setting to prepare individuals for outpatient pulmonary rehab upon discharge.

This guide details Sinai Post-Acute, Nursing & Rehab Center’s Post-Acute Pulmonary Rehabilitation program. The program incorporates respiratory therapy, physical therapy training, psychosocial support, nutritional education, and home care services.


Care Team

The pulmonary program’s multi-disciplinary team includes:

• Pulmonologist (or attending physician)
• Physiatrist
• Nursing Mangers
• Respiratory Therapy
• Physical/Occupational Therapy
• Speech Therapist
• Dietitian
• Social Service

Pulmonary Recovery Program Process

When a patient is admitted with a pulmonary diagnosis, the nurse manager will contact the attending physician to see if they would like the resident to be assessed for the pulmonary program. Some attending physicians may prefer to have a consult ordered on all pulmonary admissions.

If approved, the nursing manager will call in a consult for the Pulmonologist or respiratory therapist. If the patient is determined to be a candidate, the Pulmonologist or attending physician will write an order for the pulmonary recovery program.

The order will prompt the following consults:

• Pulmonologist – Scheduled weekly visit and on-call phone consultations
• Physiatrist – Assessment for rehab exercise program
• Respiratory Therapy – Instruction for respiratory exercises
• Dietitian – Assessment for nutritional education
• Speech Therapy – Assessment for speech exercises & dysphagia when necessary
• Nursing – Management of pulmonary focused care plan


Exercise Program

• Respiratory Exercise – The respiratory therapist will initiate respiratory exercises. The patient will be instructed on breathing exercises such as purse lip breathing, abdominal breathing, and incentive spirometry.

• Physical Therapy – The physical exercise prescription will be individually assessed. Standard orders include strength building of the upper limb and lower extremities. Equipment will be made available to rehab department that can increase exercise tolerance including a chest precursor & Breathe NIOV.

• Occupational/Speech/Nutrition – Each participant will be individually advised on occupational therapy, smoking cessation, speech therapy, nutrition, and comprehensive disease education.

• Nursing – Nursing will administer incentive spirometry three-times per day and facilitate protocols to increase functional ADLs.

• Oxygen Titration – Oxygen saturation will be regularly monitored and prescribed based on achieving target levels. The goal is to decrease or eliminate the need for supplemental oxygen.

Discharge Planning

The benefits derived from the pulmonary program are only as extensive as the individual’s willingness to practice what they have learned on a regular basis. Each participant will be given a list of exercises that can be perform concurrently with supervised sessions. Upon discharge, a home exercise program will be recommended to maintain the benefits gained from the program.

Upon discharge, participants will be under the supervision of the attending physicians and be referred back to their Pulmonologist. Outpatient pulmonary rehab can be recommending if the patient qualifies.

Homecare DME providers will be contacted to delivery any necessary equipment prior to discharge.