Impact of an emergency department nurse training intervention on the adequacy of thromboprophylaxis for venous thromboembolism: the PROTESU III study

• Published in: Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias Vol. 36; no. 5; p. 359
• Main Authors: Rincón Díaz, César, Jiménez Hernández, Sònia, Beddar Chaib, Fahd, Lozano Polo, Laura, Guirado Torrecillas, Leticia, Cortés Ayaso, María, Condon Abanto, Ana Isabel, Pedraza García, Jorge, Muñoz Gamito, Gema, Jiménez, David, Lecumberri, Ramón, Ruiz Artacho, Pedro, Representación Del Grupo de Trabajo de Enfermedad Tromboembólica Venosa de la Sociedad Española de Medicina de Urgencias Y Emergencias Etv-Semes, En
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.06.2024
• Subjects: Adult; Aged; Anticoagulants - therapeutic use; Emergency Nursing - education; Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Venous Thromboembolism - prevention & control; Emergency department; Nursing; Thromboembolic disease; Enfermedad tromboembólica venosa; Preventive therapy; Profilaxis; Enfermería; Urgencias
• ISSN: 2386-5857

Objectives. To assess the impact of training for emergency department (ED) nurses on adequate thromboprophylaxis for patients admitted to hospital from the ED for medical conditions. Methods. Multicenter quasiexperimental pre-post study of an ED nurse training intervention in 8 hospitals. Patients were recruited from January 2022 through May 2023 in 3 phases: before nurse training, in the first month after training, and in the sixth month after training. Included were patients attended in the ED for medical conditions. Adequate thromboprophylaxis was defined as 1) use of prophylactic drugs in patients at high risk for venousthromboembolism according to the Padua Prediction Score (PPS), and 2) nonuse in patients at low risk. We compared the percentage of adequate prophylaxis in the first phase to the percentages in the second and third phases. Results. A total of 928 patients were included (326 in phase 1, 295 in phase 2, and 307 in phase 3). PPS scores indicated that 238 (73%) of the patients were at high risk in phase 1 vs 189 (64.1%, P = .016) in phase 2 and 207 (67.4%, P = .125) in phase 3. A total of 187 patients (57.4%, 95% CI, 51.8%-62.8%) were adequatelythromboprophylaxed in phase 1 vs 178 (60.%, 95% CI, 54.5%-66%) in phase 2 (absolute difference in proportions, 3.0% (95% CI, -4.8% to 10.6%; P = .462)]. In phase 3, 166 patients (54.1%, 95% CI, 48.3%-59.7%) received adequate prophylaxis (difference, -3.3% (95% CI, -11.0% to 4.4%; P = .405). Conclusions. A training intervention for ED nurses, implemented as an isolated strategy, had no impact on the adequacy of thromboprophylaxis in patients admitted from the ED for medical conditions.