Department of Intensive Care, King Abdulaziz Medical City-Riyadh, Saudi Arabia ; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, City-Riyadh Saudi Arabia.
Ann Thorac Med. 2013 Jul;8(3):165-9. doi: 10.4103/1817-1737.114298.
Didactic lectures are frequently used to improve compliance with practice guidelines. This study assessed the knowledge of health-care providers (HCPs) at a tertiary-care hospital of its evidence-based thromboprophylaxis guidelines and the impact of didactic lectures on their knowledge.
The hospital launched a multifaceted approach to improve thromboprophylaxis practices, which included posters, a pocket-size guidelines summary and didactic lectures during the annual thromboprophylaxis awareness days. A self-administered questionnaire was distributed to HCPs before and after lectures on thromboprophylaxis guidelines (June 2010). The questionnaire, formulated and validated by two physicians, two nurses and a clinical pharmacist, covered various subjects such as risk stratification, anticoagulant dosing and the choice of anticoagulants in specific clinical situations.
Seventy-two and 63 HCPs submitted the pre- and post-test, respectively (62% physicians, 28% nurses, from different clinical disciplines). The mean scores were 7.8 ± 2.1 (median = 8.0, range = 2-12, maximum possible score = 15) for the pre-test and 8.4 ± 1.8 for the post-test, P = 0.053. There was no significant difference in the pre-test scores of nurses and physicians (7.9 ± 1.7 and 8.2 ± 2.4, respectively, P = 0.67). For the 35 HCPs who completed the pre- and post-tests, their scores were 7.7 ± 1.7 and 8.8 ± 1.6, respectively, P = 0.003. Knowledge of appropriate anticoagulant administration in specific clinical situations was frequently inadequate, with approximately two-thirds of participants failing to adjust low-molecular-weight heparin doses in patients with renal failure.
Education via didactic lectures resulted in a modest improvement of HCPs' knowledge of thromboprophylaxis guidelines. This supports the need for a multifaceted approach to improve the awareness and implementation of thromboprophylaxis guidelines.
讲授式讲座常用于提高医疗保健提供者（HCP）对实践指南的依从性。本研究评估了一家三级保健医院的 HCP 对其基于证据的血栓预防指南的了解程度，以及讲授式讲座对其知识的影响。
医院采取了多方面的方法来改善血栓预防措施，包括张贴海报、小册子摘要和在年度血栓预防意识日进行讲授式讲座。在进行血栓预防指南讲座前后（2010 年 6 月），向 HCP 分发了一份自我管理的问卷。该问卷由两名医生、两名护士和一名临床药剂师制定和验证，涵盖了各种主题，如风险分层、抗凝剂剂量和特定临床情况下抗凝剂的选择。
72 名和 63 名 HCP 分别提交了测试前和测试后的问卷（62%为医生，28%为护士，来自不同的临床学科）。测试前的平均得分为 7.8 ± 2.1（中位数=8.0，范围=2-12，最大可能得分=15），测试后的平均得分为 8.4 ± 1.8，P=0.053。护士和医生的测试前得分没有显著差异（分别为 7.9 ± 1.7 和 8.2 ± 2.4，P=0.67）。对于完成了测试前和测试后的 35 名 HCP，他们的得分分别为 7.7 ± 1.7 和 8.8 ± 1.6，P=0.003。在特定临床情况下适当使用抗凝剂的知识经常不足，大约三分之二的参与者未能调整肾衰竭患者的低分子肝素剂量。
通过讲授式讲座进行教育，使 HCP 对血栓预防指南的知识有了适度的提高。这支持需要采取多方面的方法来提高对血栓预防指南的认识和实施。
