Salisbury University.
Workplace Health Saf. 2023 Oct;71(10):465-475. doi: 10.1177/21650799231184374. Epub 2023 Jul 17.
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States, with 20% of deaths in adults under age 65. Commercial drivers have an increased CVD incidence rate of 50% compared to 30% for the general population, yet one third of drivers will not be screened for risk factors due to a lack of insurance or primary care. With approximately 3.5 million commercial drivers nationally and correlation of CVD to increased motor vehicle accidents, fatalities, and excessive healthcare costs, addressing the care gap for this high-risk population is imperative.
An evidence-based practice (EBP) project synthesized the literature and implemented CVD risk screening for commercial drivers examined in an occupational practice setting. Using the non-laboratory Framingham CVD risk score calculator, over 90% of drivers were screened during mandated medical examinations and provided education regarding modifiable risk factors during a 2-month period.
Over 40% of commercial drivers were at high risk for CVD with 25% uninsured and 32% without primary care. The average CVD risk score was twice the general population's risk score, with obesity, hypertension, and smoking being the most common risk factors discussed.
CONCLUSIONS/APPLICATION TO PRACTICE: Incorporating CVD risk screening and education during opportune encounters is logical, efficient, and financially prudent. The EBP change supports occupational professionals' standards, and ongoing review of CVD screening guidelines with integration into practice provides health promotion and promotes public safety for these essential workers.
心血管疾病(CVD)仍然是美国发病率和死亡率的主要原因,65 岁以下成年人中有 20%的人因此死亡。与普通人群 30%的发病率相比,商业司机的 CVD 发病率增加了 50%,但由于缺乏保险或初级保健,三分之一的司机将不会接受危险因素筛查。全国约有 350 万商业司机,CVD 与机动车事故、死亡和过度医疗费用增加相关,因此必须解决这一高危人群的护理差距。
循证实践(EBP)项目综合了文献,并在职业实践环境中对商业司机进行 CVD 风险筛查。在为期两个月的时间里,使用非实验室Framingham CVD 风险评分计算器,对 90%以上的司机进行了筛查,并提供了有关可改变风险因素的教育。
超过 40%的商业司机有 CVD 高风险,其中 25%的人没有保险,32%的人没有初级保健。CVD 风险评分的平均值是普通人群风险评分的两倍,最常见的风险因素是肥胖、高血压和吸烟。
结论/对实践的应用:在适当的机会中纳入 CVD 风险筛查和教育是合理、高效且经济审慎的。EBP 变革符合职业专业人员的标准,并且随着将 CVD 筛查指南纳入实践的持续审查,提供了健康促进,并为这些重要的工作人员促进了公共安全。