Education and practice gaps on atrial fibrillation and anticoagulation: A survey of cardiovascular nurses

Ferguson, C; Inglis, SC; Newton, PJ; Middleton, S; Macdonald, PS; Davidson, PM

Education and practice gaps on atrial fibrillation and anticoagulation: A survey of cardiovascular nurses

Ferguson, C

Inglis, SC

Newton, PJ

Middleton, S

Macdonald, PS

Davidson, PM

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Publication Type:: Journal Article
Citation:: BMC Medical Education, 2016, 16 (1)
Issue Date:: 2016-01-12

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Field	Value	Language
dc.contributor.author	Ferguson, C https://orcid.org/0000-0002-2417-2216	en_US
dc.contributor.author	Inglis, SC https://orcid.org/0000-0002-1331-5912	en_US
dc.contributor.author	Newton, PJ https://orcid.org/0000-0002-5006-2037	en_US
dc.contributor.author	Middleton, S https://orcid.org/0000-0002-7201-4394	en_US
dc.contributor.author	Macdonald, PS https://orcid.org/0000-0001-5378-2825	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.date.available	2015-12-07	en_US
dc.date.issued	2016-01-12	en_US
dc.identifier.citation	BMC Medical Education, 2016, 16 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/41166
dc.description.abstract	© 2016 Ferguson et al. Background: Patients' knowledge of their atrial fibrillation (AF) and anticoagulation therapy are determinants of the efficacy of thromboprophylaxis. Nurses may be well placed to provide counselling and education to patients on all aspects of anticoagulation, including self-management. It is important that nurses are well informed to provide optimal education to patients. Current practice and knowledge of cardiovascular nurses on AF and anticoagulation in the Australian and New Zealand (ANZ) context is not well reported. This study aimed to; 1) Explore the nurse's role in clinical decision making in anticoagulation in the setting of AF; 2) Describe perceived barriers and enablers to anticoagulation in AF; 3) Investigate practice patterns in the management of anticoagulation in the ANZ setting; 4) Assess cardiovascular nurses' knowledge of anticoagulation. Methods: A paper-based survey on current practices and knowledge of AF and anticoagulation was distributed during the Australian Cardiovascular Nursing College (ACNC) Annual Scientific Meeting, February 2014. This survey was also emailed to Cardiovascular Trials Nurses throughout New South Wales, Australia and nursing members of the Cardiac Society of Australia and New Zealand (CSANZ). Results: There were 41/73 (56 %) respondents to the paper-based survey. A further 14 surveys were completed online via nurse members of the CSANZ, and via an investigator developed NSW cardiovascular trials nurse email distribution list. A total of 55 surveys were completed and included in analyses. Prior education levels on AF, stroke risk, anticoagulation and health behaviour modification were mixed. The CHA2DS2VASc and HAS-BLED risk stratification tools were reported to be underused by this group of clinicians. Reported key barriers to anticoagulation included; fears of patients falling, fears of poor adherence to medication taking and routine monitoring. Patient self-monitoring and self-management were reported as underutilised. ANZ cardiovascular nurses reported their key role to be counselling and advising patients on therapy regimens. Anticoagulant-drug interaction knowledge was generally poor. Conclusion: This study identified poor knowledge and practice in the areas of AF and anticoagulation. There is scope for improvement for cardiovascular nurses in ANZ in relation to AF and anticoagulation knowledge and practice.	en_US
dc.relation.ispartof	BMC Medical Education	en_US
dc.relation.isbasedon	10.1186/s12909-015-0504-1	en_US
dc.subject.classification	Medical Informatics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Atrial Fibrillation	en_US
dc.subject.mesh	Anticoagulants	en_US
dc.subject.mesh	Health Care Surveys	en_US
dc.subject.mesh	Nurse's Role	en_US
dc.subject.mesh	Clinical Competence	en_US
dc.subject.mesh	Needs Assessment	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Patient Education as Topic	en_US
dc.subject.mesh	Cardiovascular Nursing	en_US
dc.subject.mesh	Surveys and Questionnaires	en_US
dc.subject.mesh	Practice Patterns, Nurses'	en_US
dc.title	Education and practice gaps on atrial fibrillation and anticoagulation: A survey of cardiovascular nurses	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	16	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1302 Curriculum and Pedagogy	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	16	en_US

Abstract:

© 2016 Ferguson et al. Background: Patients' knowledge of their atrial fibrillation (AF) and anticoagulation therapy are determinants of the efficacy of thromboprophylaxis. Nurses may be well placed to provide counselling and education to patients on all aspects of anticoagulation, including self-management. It is important that nurses are well informed to provide optimal education to patients. Current practice and knowledge of cardiovascular nurses on AF and anticoagulation in the Australian and New Zealand (ANZ) context is not well reported. This study aimed to; 1) Explore the nurse's role in clinical decision making in anticoagulation in the setting of AF; 2) Describe perceived barriers and enablers to anticoagulation in AF; 3) Investigate practice patterns in the management of anticoagulation in the ANZ setting; 4) Assess cardiovascular nurses' knowledge of anticoagulation. Methods: A paper-based survey on current practices and knowledge of AF and anticoagulation was distributed during the Australian Cardiovascular Nursing College (ACNC) Annual Scientific Meeting, February 2014. This survey was also emailed to Cardiovascular Trials Nurses throughout New South Wales, Australia and nursing members of the Cardiac Society of Australia and New Zealand (CSANZ). Results: There were 41/73 (56 %) respondents to the paper-based survey. A further 14 surveys were completed online via nurse members of the CSANZ, and via an investigator developed NSW cardiovascular trials nurse email distribution list. A total of 55 surveys were completed and included in analyses. Prior education levels on AF, stroke risk, anticoagulation and health behaviour modification were mixed. The CHA2DS2VASc and HAS-BLED risk stratification tools were reported to be underused by this group of clinicians. Reported key barriers to anticoagulation included; fears of patients falling, fears of poor adherence to medication taking and routine monitoring. Patient self-monitoring and self-management were reported as underutilised. ANZ cardiovascular nurses reported their key role to be counselling and advising patients on therapy regimens. Anticoagulant-drug interaction knowledge was generally poor. Conclusion: This study identified poor knowledge and practice in the areas of AF and anticoagulation. There is scope for improvement for cardiovascular nurses in ANZ in relation to AF and anticoagulation knowledge and practice.

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http://hdl.handle.net/10453/41166