Date of Graduation

Fall 12-12-2014

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions



First Advisor

Dr. Juli Maxworthy

Second Advisor

Dr. Amy Nichols

Third Advisor

Dr. Mary Bittner


A significant number of Acute Myocardial Infarction (AMI) patients were readmitted to an urban San Francisco Medical Center within 5-7 days post discharge this year. Two of the main identified causes were symptom management issues and medication instructions, both of which are part of the discharge instructions. It’s not surprising that 80% of all discharge teaching is forgotten by patients by the time they hit the parking lot. With the recommended timeframe for post discharge follow up appointments at 48 to 72 hours post discharge and as those appointments are not typically available within the recommended timeframe, patients are more likely to be readmitted unless an alternative for post discharge follow up can be created. The intent of this project is to propose the implementation of a hospital based Cardiac Rehabilitation (CR) program that allows AMI patients to participate as early as 48 -72 hours post discharge. This first part, or intake to the CR program would reinforce discharge teaching inclusive of medication reconciliation, symptom management, and all other components taught at discharge. The evidence to be duplicated is that enrollment in a certified cardiac rehab program as early as 48 hours post discharge can prevent readmissions by enhancing the patient/family’s retention and understanding of discharge instructions that include symptom management and medication