Venous thromboembolism in the emergency department: A survey of current best practice awareness in physicians and nurses in China

doi:10.5847/wjem.j.1920-8642.2019.01.001

Abstract

Abstract:

BACKGROUND: For emergency department (ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism (VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE.
METHODS: We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 software.
RESULTS: In this survey, 180 questionnaires were distributed and 174 valid responses (response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no significant differences were found with respect to job (doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses’ current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years (n=83) scored significantly higher on the questionnaire than those under 5 years (n=91) (95.75 vs. 79.97, P=0.039). There was a significant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working lifetime.
CONCLUSION: Our survey has shown deficiencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events (including VTE).

Key words: Emergency, Venous thromboembolism, Staff knowledge, Emergency doctor, Emergency nurse

Wen-hua Zhou, Jian-qiang He, Shi-gong Guo, Joseph Walline, Xiao-ying Liu, Li-yuan Tian, Hua-dong Zhu, Xue-zhong Yu, Yi Li. Venous thromboembolism in the emergency department: A survey of current best practice awareness in physicians and nurses in China[J]. World Journal of Emergency Medicine, 2019, 10(1): 5-13.

Figures/Tables 3

Table 1

Table 2

Table 3

Distinguish category	Specific categories	Number (%)
Age	20-25 years	34 (20)
	26-30 years	53 (30)
	31-35 years	44 (25)
	36-40 years	27 (16)
	>40 years	16 (9)
Occupation	Doctor	54 (31)
Occupation	Nurse	120 (69)
Gender	Male	43 (25)
Gender	Female	131 (75)
Work duration	<1 year	21 (12)
	1-2 years	20 (11)
	3-5 years	41 (24)
	6-9 years	25 (14)
	10-19 years	51 (29)
	20-30 years	15 (9)
	>30 years	11 (1)
Educational status	Technical secondary school	3 (2)
	College-equivalent degree	32 (18)
	Undergraduate degree	95 (55)
	Graduate degree	29 (17)
	Master’s degree or above	15 (8)
Professional title	Primary title	115 (66)
	Intermediate title	53 (30)
	Senior title	6 (4)
Work duration ER	<3 months	21 (12)
	3-6 months	6 (3)
	6 months to 1 year	14 (8)
	1 year	4 (2)
	2 years	16 (9)
	3-5 years	30 (17)
	>5 years	83 (49)
Hospital condition	Peking Union Medical College Hospital	143 (82)
	Other tertiary-level hospitals in Beijing	7 (4)
	Second-level hospitals in Beijing	4 (2)
	Tertiary-level hospitals outside Beijing	11 (7)
	Second-level hospitals outside Beijing	2 (1)
	Other hospitals	7 (4)
Nurse’s workspace	Office treatment	18 (15)
	International ER	11 (9)
	Observation area	18 (15)
	West courtyard ER	10 (8)
	Triage area	7 (6)
	General ward	20 (17)
	EICU	20 (17)
	Resuscitation room	16 (13)

Score section	20-29	30-39	40-49	50-59	60-69	70-79	Total
Mean±SD	24.95±2.978	34.22±2.587	45.15±3.169	55.01±2.816	64.19±2.508	70.67±0	60.10±16.53
Number	14	18	52	54	35	1	174

Category	Specific groups	Percentage score (mean±SD)	Bonferroni correction	P value
Occupation	Doctor	50.07±12.131	0.05	0.636
	Nurse	49.14±11.883
Work duration	<1 year	46.03±12.115	0.002	0.287
	1-2	46.67±11.847
	3-5	48.68±14.453
	6-9	48.64±9.118
	10-19	51.27±11.099
	20-30	54.84±10.252
	>30	52.00±0
Educational status	Technical secondary school	51.56±2.037	0.005	0.696
	College degree	48.29±13.693
	Undergraduate degree	49.47±11.603
	Graduate degree	48.32±13.869
	Master’s degree or above	53.33±5.702
Professional title	Primary title	48.14±12.245	0.016	0.104
	Intermediate title	51.57±11.204
	Senior title	55.33±8.631
Work duration ER	<3 months	47.43±8.729	0.002	0.044
	3-6 months	37.11±19.712
	6 months to 1 year	47.81±13.434
	1 year	45.67±14.902
	2 years	45.17±11.281
	3-5 years	51.24±12.348
	>5 years	51.45±11.048
Hospital condition	Peking Union Medical College Hospital	49.14±11.942	0.003	0.877
	Other tertiary-level hospitals in Beijing	53.52±6.904
	Second-level hospital in Beijing	54.00±5.812
	Tertiary-level hospital outside Beijing	48.12±13.432
	Second-level hospitals outside Beijing	48.00±16.971	0.005	0.110
	Other hospitals	51.24±16.562
Nurse’s workspace	Office treatment	51.73±14.377
	International ER	43.11±9.450
	Observation area	47.76±8.408
	West courtyard ER	46.59±12.250
	Triage area	54.80±6.724
	General ward	52.00±12.244
	EICU	52.80±12.908
	Resuscitation room	47.17±11.530

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